Cervical cancer biopsy reporting: a review

Area of Science:

• Gynecologic Pathology
• Cervical Cytopathology
• Oncology

Background:

• Inconsistent terminology for human papillomavirus (HPV)-associated cervical lesions causes diagnostic confusion.
• Previous classification systems for cervical biopsies and cytology specimens have evolved, leading to interpretation challenges for clinicians.

Purpose of the Study:

• To provide a comprehensive overview of current terminology for reporting cervical biopsies and cytology.
• To discuss the Lower Anogenital Squamous Terminology (LAST) recommendations and the 2001 Bethesda Workshop (Bethesda System) guidelines.
• To highlight the utility of biomarkers like p16 and Ki-67 in challenging diagnostic scenarios.

Main Methods:

• Review of current literature and consensus recommendations on cervical lesion terminology.
• Presentation of microscopic features of cervical squamous lesions in both tissue and cytology samples.
• Discussion of the application of immunohistochemical biomarkers (p16, Ki-67) in pathology.

Main Results:

• The review synthesizes the LAST recommendations for tissue specimens and the Bethesda System for cytology.
• Key microscopic features differentiating various grades of cervical squamous lesions are detailed.
• The role of p16 and Ki-67 in improving diagnostic accuracy for ambiguous cases is explained.

Conclusions:

• Standardized terminology, such as LAST and Bethesda System, is crucial for consistent interpretation of cervical pathology reports.
• Understanding microscopic features and utilizing biomarkers like p16 and Ki-67 can enhance diagnostic confidence.
• Clear communication and updated terminology are essential for effective management of patients with HPV-related cervical changes.