The histological classification of the pre-neoplastic lesions of the cervix contemplates three categories, cervical intraepithelial neoplasia (CIN) grades 1, 2 and 3. This classification is based on a subjective assessment of the thickness of the affected epithelium: CIN1 is considered the affectation of a third or less, while the thickness of the affected epithelium in CIN3 affects more than two-thirds of its thickness. It is established that the really pre-cancerous lesion is the CIN3. But between CIN1 and CIN3 we have the CIN2, an equivocal diagnosis, given the established very low inter-observer agreement to establish its diagnosis, about 30% according to data available in the literature.
We have today a biomarker, the p16, a marker of viral integration, which can objectify the diagnosis of CIN2 and, consequently, improve its concordance and diagnostic safety.
To assess inter and intra-observer agreement in the diagnosis of CIN 1 - 2 and 3, and to study how the use of the p16 modifies these values.
We collected 100 biopsies of cervix diagnosed with CIN2 from our records between 1997 and 2007. We performed p16 in all of them.
In a first phase, three expert pathologists evaluated 297 cervix biopsies, including cases of CIN2 randomly inserted along with cases of CIN 1, CIN 3 and invasive carcinoma of the cervix. They have subsequently analyzed p16 separately. In a third phase, the CIN2 biopsies have been passed along with their corresponding p16 for assessment and diagnosis. To conclude, 150 of the 297 biopsies were randomly selected to evaluate inter-observer agreement.
The final results of the work will be presented at the Congress.
The final results of the work will be presented at the Congress.
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