title: Endocervical glandular involvement, positive endocervical surgical margin and multicentricity are more often associated with high-grade than low-grade squamous intraepithelial lesion.
abstract: OBJECTIVE
  The aim of this study was to compare the relative frequencies of endocervical glandular involvement (EGI), multicentricity, positive endocervical surgical margins (ESM) and positive vaginal surgical margins (VSM), and adenocarcinoma in situ of the cervix (AIS) between high-grade and low-grade squamous intraepithelial lesions (HSIL and LSIL, respectively).
  
  
  METHODS
  We identified 238 patients with squamous intraepithelial lesions/cervical intraepithelial neoplasia (CIN) who were treated by loop electrocautery excision (LEEP) or conventional cold-knife conization (CKC). A total of 223 (72 [32.3%] LSIL/CIN I; 85 [38.1%] HSIL/CIN II; 66 [29.6%] HSIL/CIN III; and 151 [67.7%], HSIL/CIN II + III) LEEP/CKC slides were histologically reviewed.
  
  
  RESULTS
  The frequencies of EGI, positive ESM, and multicentricity were significantly higher in the HSIL/CIN II + III group than in the LSIL/CIN I group (P = 0.001, 0.001, and 0.025, respectively). Eighteen of the 72 (25%) LSIL/CIN I patients, 44 of the 85 (51.8%) HSIL/CIN II patients, and 60 of the 66 (90.9%) HSIL/CIN III patients (P = 0.001) showed EGI. In four of the 72 (5.6%) LSIL/CIN I patients, 18 of the 85 (21.2%) HSIL/CIN II patients, and 42 of the 66 (63.6%) HSIL/CIN III patients (P = 0.001), ESM was positive. Two of the 72 (2.8%) LSIL/CIN I patients, seven of the 85 (8.2%) HSIL/CIN II patients, and 11 of the 66 (16.7%) HSIL/CIN III patients (P = 0.016) were multicentric.
  
  
  CONCLUSIONS
  The current study showed that EGI, positive ESM and multicentricity were more often associated with HSIL/CIN II + III than with LSIL/CIN I. Moreover, the frequencies of EGI, multicentricity, and positive ESM increased with increasing severity of the cervical lesion. This result may influence the preference for the type of surgical procedure used for patients with cytological diagnosis of HSIL.
authors.affiliation: Pathology Department, Umraniye Education and Research Hospital, Istanbul, Turkey. gozkir@yahoo.com
authors.forename: Gozde
authors.initials: G
authors.lastname: Kır
authors.forename: Murat Hakan
authors.initials: MH
authors.lastname: Karabulut
authors.forename: Cumhur Selçuk
authors.initials: CS
authors.lastname: Topal
authors.forename: Müberra Segmen
authors.initials: MS
authors.lastname: Yılmaz
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D006801:Humans; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology*