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A Journal on Obstetrics and Gynecology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Minerva Ginecologica 1999 October;51(10):365-72
Critical review of colpo-histological results in cervical pathology
Lukic A., Musumeci M., Signore M., Sassi M. T., Alò P., Giovagnoli M. R., Vetrano G.
Background. The objective of this paper was to evaluate the role of squamous metaplasia in the determination of certain colposcopic appearances.
Methods. One thousand four hundred and six infertile outpatients, attending assisted reproduction techniques, underwent a '' first level '' colposcopy. Two hundred fifty nine abnormal trasformation zones were biopsied and the histologic diagnoses were subdivided as follows: squamous metaplasia, squamous metaplasia+koilocytosis, isolated koilocytosis, condyloma, CIN+HPV, cervicitis.
Results. Two hundred forty seven cases out of 259 biopsied colposcopic findings (95.4%) were colposcopically classified as grade 1 abnormal trasformation zone (thin white epithelium, regular mosaic and punctation). The correlation between 247 grade 1 abnormal transformation zone colposcopic patterns and histologic diagnosis revealed 105 (42.5%) histologic findings described as squamous metaplasia that resulted immature in 63% of these samples. Between 132 (53.4%) cases that presented a pattern of human papillomavirus infection (condyloma, squamous metaplasia + koilocytosis or isolated koylocitosis), quite two thirds (62%) were described as condylomas, one third (31%) as squamous metaplasia associated with koylocitosis and only 7% as isolated koylocitosis. In conclusion, 42.5% of target biopsies performed on low grade abnormal trasformation of the cervix revealed squamous metaplasia, more than half of them revealed one of HPV infection forms, while only 2% represented cervical intraephitelial neoplasia.
Conclusions. Among the low risk female population, one out of two cases of colposcopically low grade pattern should be considered indicative of squamous metaplasia. The results obtained confirm that colposcopic evaluation is unable to distinguish between immature metaplastic trasformation of the epithelium and metaplastic epithelium with initial neoplastic trasformation.