Revised Terminology for Cervical Histopathology and Its Implications for Management of High-Grade Squamous Intraepithelial Lesions of the Cervix

Abstract

In March 2012, the College of American Pathologists and American Society for Colposcopy and Cervical Pathology, in collaboration with 35 stakeholder organizations, convened a consensus conference called the Lower Anogenital Squamous Terminology (LAST) Project. The recommendations of this project include using a uniform, two-tiered terminology to describe the histology of human papillomavirus-associated squamous disease across all anogenital tract tissues: vulva, vagina, cervix, penis, perianus, and anus. The recommended terminology is "low-grade" or "high-grade squamous intraepithelial lesion (SIL)." This terminology is familiar to clinicians, because it parallels the terminology of the Bethesda System cytologic reports. Biopsy results using SIL terminology may be further qualified using "intraepithelial neoplasia" (IN) terminology in parentheses. Laboratory p16 tissue immunostaining is recommended to better classify histopathology lesions that morphologically would earlier have been diagnosed as IN 2. p16 is also recommended for differentiating between high-grade squamous intraepithelial lesions and benign mimics. The LAST Project recommendations potentially affect the application of current guidelines for managing cervical squamous intraepithelial lesions. The authors offer interim guidance for managing cervical lesions diagnosed using this new terminology with special attention paid to managing young women with cervical high-grade squamous intraepithelial lesions on biopsy. Clinicians should be aware of the LAST Project recommendations, which include important changes from prior terminology. HHS Public Access

Evaluation of Expression of 4 Mirnas in Cytological Samples as an Additional Method of Cervical Cancer Diagnosis

“…-результаты лабораторных исследований (ин-фицированность вирусом папилломы человека высо-кого онкогенного риска, экспрессия онкопротеина p16 / INK4a), -клинические данные (возраст пациентки, анамнез, длительность / динамика наблюдаемой па-тологии) [7,8].…”

Quantitative DNA methylation analysis of paired box gene 1 and LIM homeobox transcription factor 1 α genes in cervical cancer

“…CIN is a group of cervical lesions that are associated with CC and are divided into three grades (I, II and III) (6,7). The majority of low-grade CIN cases naturally subside, but high-grade lesions continue to develop and break through the sub-epithelial basement membrane, at which point they are referred to as cervical invasive carcinoma (7,8). Histology is currently the basis for the diagnosis and classification of CIN (6).…”

“…CC originating from cervical intraepithelial neoplasia (CIN) is often caused by high risk-human papilloma virus (HR-HPV) infection (5). CIN is a group of cervical lesions that are associated with CC and are divided into three grades (I, II and III) (6,7). The majority of low-grade CIN cases naturally subside, but high-grade lesions continue to develop and break through the sub-epithelial basement membrane, at which point they are referred to as cervical invasive carcinoma (7,8).…”

Comparison of the diagnostic value of cervical cytology and HPV HR DNA testing for the diagnosis of low-grade and high-grade squamous intraepithelial lesions across different age groups

“…Lesions previously classified as CIN 2 should be tested immunohistochemically in order to detect the expression of p16 protein. Lesions negative for p16 should be classified as LSIL, while lesions positive for p16 should be classified as HSIL [3,4].…”