Correlation between VITOM(®) videocolposcopy and histopathology for pathognomonic grading criteria

Area of Science:

• Gynecologic pathology
• Colposcopy and cervical cancer screening
• Histomorphology and diagnostic accuracy

Background:

• Colposcopic criteria for high-grade cervical intraepithelial neoplasia (CIN) require histopathological confirmation.
• Four specific colposcopic signs (inner border, ridge, rag, cuffed gland openings) are considered pathognomonic for CIN 2/3.
• Understanding the precise histomorphologic correlation of these signs is crucial for accurate diagnosis.

Purpose of the Study:

• To investigate the histomorphologic equivalents of four pathognomonic colposcopic criteria.
• To determine the association of these colposcopic signs with CIN 2 and/or CIN 3.
• To validate the reliability of these colposcopic signs in predicting high-grade cervical lesions.

Main Methods:

• Videocolposcopy (VITOM®) was used to identify inner border, ridge, rag, and cuffed gland openings in 255 patients.
• Histopathological examination included immunohistochemical staining (p16, Ki 67, stathmin-1) and micro-photography.
• Correlation between colposcopic findings and histopathological diagnoses was analyzed.

Main Results:

• Specific histopathologic patterns were identified for each of the four colposcopic signs.
• These colposcopic criteria were highly associated with CIN 2 or 3 (97-98% accuracy).
• Combinations of these signs were frequent, with ridge sign being the most common secondary criterion.

Conclusions:

• The morphology of the four pathognomonic colposcopic signs (inner border, ridge, rag, cuffed gland openings) is accurately reproduced in histopathology.
• These colposcopic criteria demonstrate a high association with CIN 2 or CIN 3, confirming their diagnostic value.