Cytological status and lesion size: a further dimension in cervical intraepithelial neoplasia


  • Department of Histopathology

  • Department of Gynaecology

  • Department of Epidemiology, Imperial Cancer Research Fund, Lincoln's Inn Fields, London WC2

M. R. Jarmulowicz, Dept of Histopathology, Royal Free Hospital, London NW3


Summary. Quantitative histological study of 84 laser cone biopsies showed a highly significant correlation between the grade of a cervical smear and the size of the lesion for all grades of cervical intraepithelial neoplasia (CIN) (CIN 1 P= 0·004; CIN II P= 0·0001; C1N 111 P= 0·003; total CIN P< 0·0001); 10 of 34 (29%) of women with CIN III and mild dyskaryosis or less had significantly smaller lesions than 23 of 36 (63%) of women with CIN III and moderate or severe dyskaryosis. Repeat cytology identified as severe dyskaryosis all those with large CIN III lesions. Lesion size has been neglected in studies of the natural history of CIN and in the assessment of cytological screening, but offers an explanation for the apparent discrepancies between cytological, colposcopic and histological assessment of progression of CIN.