title: Correlation between VITOM(®) videocolposcopy and histopathology for pathognomonic grading criteria.
abstract: OBJECTIVE
  "Every colposcopic criterion must be mirrored by histopathology". We investigated the histomorphologic equivalent of four colposcopic criteria, which are associated with CIN 2 and/or CIN 3 and therefore called pathognomonic.
  
  
  METHODS
  We diagnosed inner border sign, ridge sign, rag sign and/or cuffed gland openings using VITOM(®) videocolposcopy in 255 patients which are consistent with major change. Histopathologic examination included immunohistochemical staining for p16, Ki 67 and stathmin-1 and micro-photographic documentation.
  
  
  RESULTS
  The histopathologic pattern specific for each of the four pathognomonic colposcopic criteria was reproducibly identified: inner border sign showed a sharp demarcation between low- and high-grade CIN, in ridge sign high-grade CIN adjoined directly the squamocolumnar junction, in rag sign, high-grade CIN was detached from stroma, and in cuffed gland openings, the entrance to a gland was rimmed by CIN, respectively. In 255 patients, the leading pathognomonic sign was inner border in 12.1 %, ridge in 34.1 %, rag in 18 %, and cuffed glands in 35.7 %, respectively. Inner border sign, ridge sign, rag sign and/or cuffed gland openings were associated with CIN 2 or 3 in 97, 98, 98 and 98 %, respectively. In 153 out of 255 patients, we found a combination of pathognomonic signs with ridge sign being the most frequent combined criterion (in 21 % of patients as second pathognomonic sign).
  
  
  CONCLUSIONS
  The morphology of the four pathognomonic colposcopic criteria, inner border sign, ridge sign, rag sign and cuffed crypt openings, is reproduced in histopathology. These criteria are highly associated with CIN 2 or CIN 3.
authors.affiliation: Institute for Dysplasia and Cytology, Hollenzollerndamm 123, 14199, Berlin, Germany. Schneider@izd-berlin.de.
authors.forename: A
authors.initials: A
authors.lastname: Schneider
authors.affiliation: Institute for Dysplasia and Cytology, Hollenzollerndamm 123, 14199, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Rakozy
authors.affiliation: Institute for Dysplasia and Cytology, Theater Str. 14, 30159, Hannover, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Stolte
authors.affiliation: Institute for Dysplasia and Cytology, Kasseler Landstrasse 25b, 37081, Göttingen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Bothur-Schäfer
authors.affiliation: Institute for Dysplasia and Cytology, Kasseler Landstrasse 25b, 37081, Göttingen, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Rothe
authors.affiliation: Institute for Dysplasia and Cytology, Kasseler Landstrasse 25b, 37081, Göttingen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Welcker
authors.affiliation: Institute for Dysplasia and Cytology, Hollenzollerndamm 123, 14199, Berlin, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Choly
authors.affiliation: Institute for Dysplasia and Cytology, Hollenzollerndamm 123, 14199, Berlin, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Roesgen
authors.affiliation: Institute for Dysplasia and Cytology, Theater Str. 14, 30159, Hannover, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Böhmer
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D003127:Colposcopy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010781:Photography; D010808:Physical Examination; D011237:Predictive Value of Tests; D011247:Pregnancy; D015203:Reproducibility of Results; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
keywords: Colposcopy; Histology; Immunohistochemistry; Pathognomonic signs