Cytological and Histopathological Associations of Cervical Intrapithelial Neoplasia Grade 2 and Characteristics of Cyclin D1 Expression in Women with Irregular Menstrual Cycle
G Burkadze, N Chogoladze, M Gudadze, M Gachechiladze. Central University Hospital, Tbilisi, Georgia
Background: Identification of cervical intraepithelial neoplasias (CIN) in routine Pap smears is achieved based on the cytological criteria by the Bethesda System for Reporting Cervical Cytology. However, these criteria do not take into account a phase or regularity of menstrual cycle. We set out to test the hypotheses that irregular period is of importance in diagnosing CIN2, and cyclin D1 is a useful biomarker of cervical dysplasia.
Design: We studied 85 women with cytological diagnosis of CIN2 in cervical Pap smears, including 23 reproductive patients with regular period (group 1), 42 reproductive patients with irregular period (group 2), and 20 postmenopausal patients (group 3). Cervical biopsies were taken from all patients and routine histopathologic examination and immunohistochemistry were carried out using anti-Ki-67 and cyclin D1 antibodies.
Results: Histological examination confirmed CIN2 in 78.3% (18/23) of patients from group 1, 66.7% (28/42) of patients from group 2, and 80% (16/20) of patients from group 3. Immature squamous metaplasia was seen in two patients (8.9%) from group 1, ten patients (23.8%) from group 2 and three patients (15%) from group 3. Basal cell hyperplasia was seen in two patients (8.9%) from group 1, three patients (7.1%) from group two, and one patient (5%) from group 3. CIN3 was found in one patient (4.3%) from group 1 and one patient (2.4%) from group 2. High expression of cyclin D1 was observed in 65.2% (15/23), and low expression in 21.7% (5/23) of women from group 1. High expression of cyclin D1 was seen in 47.6% (20/42), and low expression in 42.9% (18/42) of women from group 2. High expression of cyclin D1 was observed in 40% (8/20), and low expression in 35% (7/20) of women from group 3. Ki-67 was expressed in 2/3 of epithelium in CIN2 and full thickness of epithelium in CIN3.
Conclusions: This study suggests that the discrepancy between cytological and histological diagnoses of CIN2 is primarily observed in women with irregular menstrual cycle, and this clinical information may be taken into account in diagnosing high-grade cervical dysplasia. In these patients cyclin D1 expression was not associated with CIN2, and this biomarker does not seem to provide additional information in differential diagnosis.
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 80, Tuesday Morning