Accuracy of cervical specimens obtained for biomarker studies in women with CIN3.
OBJECTIVE
We developed a protocol to collect representative cervical specimens based on colposcopic evaluation from women treated with loop electrosurgical excision procedure (LEEP).


METHODS
We analyzed the histology of biopsies targeting the worst and a normal area on the cervical surface in 74 women referred for LEEP because of cervical intraepithelial neoplasia grade 3 (CIN3) detected in a previous biopsy. Lesions and normal tissue were identified in colposcopy, marked, and removed after LEEP. Cervical cytology specimens collected at the same time were analyzed using Pap cytology and human papillomavirus (HPV) genotyping.


RESULTS
All but two women had an abnormal colposcopic impression with 59 of 68 (87%) showing an impression of CIN2 or greater. In 19 of 58 (33%) women, the histology result of the frozen specimen targeting the worst lesion was < or =CIN1. In 18 of 46 (40%) women, the histology of the frozen specimen targeting normal tissue was CIN2+. A concordant histology result in specimens targeting the worst lesion was associated with a greater extension of the CIN3 in the LEEP (p trend=0.002) and a HSIL cytology result (p trend=0.02).


CONCLUSIONS
It is challenging to sample representative cervical tissue. Even in women with confirmed CIN3, colposcopy performance to identify the worst lesion on the cervix was limited. Correctly identified CIN3s were more likely to be larger lesions that may have a higher risk of progression to cancer.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Boulevard, Room 5014, Rockville, MD 20854-7234, USA. wentzenn@mail.nih.gov
Nicolas
N
Wentzensen
Rosemary E
RE
Zuna
Mark E
ME
Sherman
Michael A
MA
Gold
Mark
M
Schiffman
S Terence
ST
Dunn
Jose
J
Jeronimo
Roy
R
Zhang
Joan
J
Walker
Sophia S
SS
Wang
D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D003127:Colposcopy; D004598:Electrosurgery / Q000379:methods; D005260:Female; D005629:Frozen Sections; D006801:Humans; D013048:Specimen Handling; D002583:Uterine Cervical Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000737:chemistry / Q000473:pathology* / Q000601:surgery
D014408:Biomarkers, Tumor