Abstract

Background: Cervical cancer is the most common type of carcinoma in Indian women, and it develops after years of morphologically defined precancerous lesions. The diagnostic criteria for intraepithelial neoplasia and microinvasion vary greatly. In addition, in cases of frank malignancy, histomorphological studies aid in lesion typing, establishing stages of development and determining the extent of involvement, this is critical for prognosis and clinical management. The present study is undertaken to examine the histomorphological characteristics of premalignant and malignant lesions of the uterine cervix and to characterize them based on microscopy.
Materials and Methods: The present study was a prospective study done from June 2021 to May 2022. All histologically verified premalignant and malignant epithelial lesions of the uterine cervix received at the Department of Pathology at Kamineni Institute of Medical Sciences Narketpally were studied and classifed them using the WHO classification, examined accompanying morphological changes, and graded these lesions.
Results: There were 30 premalignant and 35 malignant uterine cervix lesions. The most common premalignant lesion was high grade squamous intraepithelial lesion (HSIL) constituting 16(53.34%) cases followed by 14 (46.66%) cases of low grade squamous intraepithelial lesion (LSIL). IHC analysis reveals p16 positivity in 7 (23.3%) cases of premalignant condition and 6 (20%) cases showed koilocytic change. Among the 35 malignant tumors, all were epithelial carcinomas. 30(85.72%) cases were Squamous Cell carcinoma, 3 (8.58%) were Adenocarcinoma and 1 (2.85%) each were neuroendocrine carcinoma and adenosquamous carcinoma.
Conclusion: Cervical cancer remains the most frequent malignancy in women in underdeveloped countries. Most of the factors associated with invasive cervical cancer in previous epidemiological studies were discovered to be connected to carcinoma in situ and dysplasia of the cervix, such as early age at first intercourse, multiple sexual partners, and pregnancy outside marriage. Histopathological examination is considered the gold standard for the identification of intraepithelial neoplasia and cervical cancer, and it should be undertaken as early as possible to provide a better prognosis, treatment, and protection against invasive cervical carcinoma.