Is there any Clinical Advantage in Separating CIN 2 from CIN 3 in the Current Two-tiered Cytological Classification?


Aim: To investigate the practical use of description for CIN 2 or CIN 3 in HSIL cytology, the objective of thepresent study is to compare the prevalence of histologic CIN 2/3 or cancer (CIN 2+) between women withcytologic CIN 2 and CIN 3.
Methods: The medical records of women with high-grade squamous intraepitheliallesion (HSIL) on cytology who underwent colposcopy at Rajavithi hospital between January 2001 and March2005 were reviewed.
Results: Of 152 women with HSIL, 70 and 82 had cytologic change compatible with CIN 2and CIN 3, respectively. Women from HSIL-CIN 3 were significantly more likely to have CIN 2/3 or cancer thanthose from HSIL-CIN 2. Histology-proved CIN 2+ was confirmed in 64.3% and 85.4% in HSIL-CIN 2 andHSIL-CIN 3, respectively (p<0.05). Invasive cancer was found in 5.7% in HSIL-CIN 2 and 9.8% HSIL-CIN 3.
Conclusion: The histologic outcome is obviously different between women with cytologic CIN 2 and CIN 3.However, both groups should be managed similarly because of the high prevalence of high-grade cervical lesionincluding invasive cancer.