Is there any clinical advantage in separating CIN 2 from CIN 3 in the current two-tiered cytological classification?
OBJECTIVE
To investigate the practical use of description for CIN 2 or CIN 3 in HSIL cytology, the objective of the present study is to compare the prevalence of histologic CIN 2/3 or cancer (CIN 2+) between women with cytologic CIN 2 and CIN 3.


METHODS
The medical records of women with high-grade squamous intraepithelial lesion (HSIL) on cytology who underwent colposcopy at Rajavithi hospital between January 2001 and March 2005 were reviewed.


RESULTS
Of 152 women with HSIL, 70 and 82 had cytologic change compatible with CIN 2 and CIN 3, respectively. Women from HSIL-CIN 3 were significantly more likely to have CIN 2/3 or cancer than those from HSIL-CIN 2. Histology-proved CIN 2+ was confirmed in 64.3% and 85.4% in HSIL-CIN 2 and HSIL-CIN 3, respectively (p<0.05). Invasive cancer was found in 5.7% in HSIL-CIN 2 and 9.8% HSIL-CIN 3.


CONCLUSIONS
The histologic outcome is obviously different between women with cytologic CIN 2 and CIN 3. However, both groups should be managed similarly because of the high prevalence of high-grade cervical lesion including invasive cancer.
Boonlikit
Sathone
S
Department of Obstetrics and Gynecology, Rajavithi Hospital, Rangsit University, Bangkok, Thailand. sathone_b@yahoo.com
Srisantiroj
Nattinee
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D003127:Colposcopy; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D002583:Uterine Cervical Neoplasms / Q000145:classification* / Q000473:pathology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000145:classification* / Q000473:pathology