Subepithelial angiogenesis in cervical intraepithelial neoplasia

A retrospective study was performed to determine whether the degree of angiogenesis progressively increases with the grade of cervical intraepithelial neoplasia (CIN).

Forty-one patients with CIN (9 with CIN1; 12 with CIN2; 20 with CIN3) noted on cone biopsy were identified, and their charts were reviewed. Patients diagnosed with CIN were compared to nine control patients who had undergone hysterectomies for benign indications. Original surgical specimens were obtained for each patient, and new slides were prepared for staining with anti-factor VIII. The number of subepithelial microvessels in four separate high-power (200×) fields was averaged for each specimen as an indirect measurement of the degree of angiogenesis.

The mean number (± SD) of subepthelial blood vessels in the control group was 12.2 ± 2.7 as compared with 23.5 ± 5.5 for patients with CIN1; 25.5 ± 10.2 for those with CIN2; and 24.3 ± 8.7 for women with CIN3. Analysis of variance revealed a significant difference in the mean number of blood vessels between groups (p = .0015). Multiple comparisons testing indicated that the mean blood vessel counts in CIN1, CIN2, and CIN3 were significantly higher as compared to controls (p < .05).

The number of subepithelial microvessels is increased in CIN. This finding suggests that the transition of normal cervical tissue to preinvasive disease involves angiogenesis.