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A cross-sectional analytical study assessing apoptotic index as a marker of disease progression in cervical dysplasia
Trupti Amol Dongre1, Pragati Jayant Karmarkar1, Vidula Prashant Gowardhan1
1Department of Pathology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India.
Introduction:
cervical cancer is a major malignancy in women. In cancer cells, there is an equilibrium between cell proliferation and apoptosis. Defects in this pathway allow cells to replicate. Therefore, the apoptotic index (AI) can be used to assess dysplasia. The aim of this study was to assess the apoptotic index of various grades of cervical epithelial dysplasia.
Methods:
slides were retrieved from women with gynaecological complaints undergoing cervical biopsy or hysterectomy at a tertiary care hospital. The histopathology slides of 140 cases were studied from March 2021 to Feb 2022. Statistical analysis: we used SocSciStatistics for calculations. The slides were examined using Olympus microscope CH 20i at 40X magnification. Five fields were selected from each slide and the number of epithelial cells was counted. The apoptotic bodies were counted and evaluated. Apoptotic index was calculated as the number of apoptotic bodies/the total number of cells in one field, which was expressed as percentage (%).
Results:
a significant difference was observed between the mild and severe dysplasia groups. In squamous metaplasia, the mean AI was 1.03, while in mild cervical dysplasia it was 1.51. For moderate cervical dysplasia, the mean AI was 3.06, and for severe dysplasia, the mean AI was 5.23. In cases with overtly malignant cervical lesions, the mean AI was 7.35.
Conclusion:
this study confirmed the clinical significance of apoptosis in evaluating the course of cervical epithelial dysplasia, which can also serve as a prognostic indicator for premalignant and malignant cervical lesions.
