Histopathological Diagnosis of Cervical Biopsies: Reduction of Sampling Errors with the Evaluation of a Third...

Cervical cancer (CC) is considered as a major public health problem; this disease affects mainly vulnerable women in poverty, causing a negative effect on a country's workforce.

To determine the histopathological diagnosis variation after examining three more levels of cervical biopsy paraffin blocks from patients with HPVI, CIN and CC.

A quantitative, retrospective correlational study was performed in a hospital with a second level of health care. We worked with 152 paraffin blocks of CIN (CIN, I, II and III) and cervical cancer samples. Currently, CIN I is considered as a set of low-grade injuries (low-grade squamous intraepithelial lesions, LSIL), while CIN II, CIN III and cancer in situ are considered as high-grade lesions (high-grade squamous intraepithelial lesions, HSIL). A slab was prepared with the 50micron block, which was subsequently cut into 5 microns; later, the same thing was done at two more levels to reevaluate the histopathological diagnosis and correlate it with the initial diagnosis issued by the institution.

During the examination of the additional block levels, a difference was observed from the initial diagnosis: of 32 cases of HPV diagnosis, there were 17 changes to CIN I; of 31 cases of CIN I, there were 4 changes to CIN II; of 30 cases of CIN II, there were 8 changes to CIN III and 1 change to invasive cancer; of 29 cases of CIN III, there were 9 changes to cancer in situ; and finally, of 14 cases of cancer in situ, there was 1 change to invasive cancer. After the statistical analysis, a value of p <0.05 was obtained, which indicated that the differences were statistically significant.

By modifying the histopathological study technique, guidelines can be given to generate a more accurate diagnosis with a more solid base, and thus, a more appropriate and timely treatment can be offered to avoid the development of cervical cancer.