Depth of Cervical Intraepithelial Neoplasia Grade 3 in Peruvian Women: Implications for Therapeutic Depth of Necrosis

Abstract

Objective: To determine the involvement of cervical intraepithelial neoplasia grade 3 (CIN3) in a population of women in a lower-resource setting.

Methods: One hundred twelve consecutive cone excision specimens with histological diagnosis of CIN3 were retrieved from the National Institute of Neoplastic Diseases in Lima Peru. Two pathologists independently evaluated each specimen microscopically and confirmed 107 cases that could be measured by optical micrometry. Depth and breadth of the lesions were measured microscopically.

Results: The mean maximal depth of cervical involvement by CIN3 was 2 ± 0.13 mm; depth was less than 3.5 mm in 89.7% of cases and less than 5 mm in 93.5%. Mean breadth of CIN3 was 7.3 ± 4.4 mm; breadth was less than 15.9 mm in 95% of cases and less than 20.5 mm in 99.7%. The correlation coefficient between breadth and depth of CIN3 was 0.61. No significant correlation was found between age and depth.

Conclusions: Depth of CIN3 involvement in a developing country is significantly deeper than that reported in the United States. Treatment selection for women with CIN3 and risk of treatment failure may vary between developing and developed countries because of the difference in the depth of lesions. Countries with underscreened populations need to consider the increased disease severity in devising treatment strategies.

Conflict of interest statement

Conflict of Interest Statement:

Miriam Cremer is a paid consultant for Merck and has received honoraria as a speaker. Philip Castle has received commercial HPV tests for research at a reduced or no cost from Roche, Qiagen, Norchip, Arbor Vita Corporation, BD, and mtm. He has been compensated financially as a member of a Merck Data and Safety Monitoring Board for HPV vaccines. Dr. Castle has been a paid consultant for Gen-Probe/Hologic, Roche, Cepheid, ClearPath, Guided Therapeutics, Teva Pharmaceutics, Genticel, Inovio, and GE Healthcare. Dr. Castle has received honoraria as a speaker for Roche and Cepheid. There are no other financial relationships or conflicts of interest to report. Jose Jeronimo has been a paid consultant for Qiagen.

Declaration of Interests

The authors report no conflicts of interest.

Figures

Figure 1

Figure 2