Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Morphological diagnosis of HPV lesions and cervical intraepithelial neoplasia (CIN) is highly reproducible
Purpose: to assess the value of individual histological criteria in the diagnosis of cervical HPV lesions. Methods: 138 women referred for colposcopic evaluation (due to abnormal PAP smears) were subjected to cervical punch b10psy The biopsies were classified as no HPV lesion, CIN 1, or CIN 2-3 by two observers independently. Kappa tests were used for interobserver agreement of the diagnosis. The presence of binucleation, multinucleation, abnormal mitosis, koilocytosis, spindle koilocytosis and dyskeratosis was similarly assessed. Results: the Kappa statistic was 0.638 (Cl 95% 0.533 - 0.743), showing substantial inter-observer agreement. Abnormal mitosis and mul-tinucleation were the two most powerful discriminators between CIN 2-3 and CIN 1. Koilocytosis proved to be the single most powerful discriminator between ClN 1 lesions ands non-HPV lesions. Conclusion: the results advocate the use of histology as the gold standard in diagnosing cervical precancerous lesions. The classical criteria can be also used to differentiate low-grade lesions, which has practical implications by avoiding the unnecessary treatment of minor abnormalities.