Preinvasive and invasive disease in women with cytological diagnosis of high-grade lesion and high-grade lesion cannot exclude microinvasion

Preinvasive and invasive disease in women with cytological diagnosis of high-grade lesion and high-grade lesion cannot exclude microinvasion

BMC Women's Health, October 2015

26449754

Nina de Siqueira Kuperman, Fábio Bastos Russomano, Yara Lucia Mendes Furtado de Melo, Saint Clair dos Santos Gomes

Cervical cancer is the third most common cancer in Brazil and has a high potential for prevention and cure. The prevalence of invasive and preinvasive disease in women with cytological diagnosis of high-grade lesion - cannot exclude microinvasion (HSIL-micro) is not known. This cross-sectional study used a cytology lab database to identify women with HSIL-micro and HSIL referred to two colposcopic units from June 2006 to December 2012. For each woman with HSIL-micro, four women with cytologic diagnosis of HSIL who met the inclusion criteria were identified. Data were obtained from review of medical records. Forty-seven patients with report of HSIL-micro and 188 patients with report of HSIL were included. The final diagnoses revealed a frequency of preinvasive lesions of 31.9 % (15/47) and 59.6 % (112/188) in patients with HSIL-micro and HSIL, respectively, while the frequency of invasive disease was 63.8 % (30/47) and 11.7 % (22/188), respectively. The HSIL-micro group showed prevalence of preinvasive or invasive disease 6.5 times greater (95 % CI = 1.6-5.7) and, for invasive disease, 2.4 times greater (95 % CI = 1.7-3.6) than the HSIL group. Higher risk of preinvasive and invasive lesions in women with cytologic diagnosis of HSIL-micro reinforces recommendations for immediate investigation.