Microinvasive cervical squamous cell carcinoma in Slovenia during the period 2001-2007; results of a retrospective review of cone biopsies

Abstract

Objective: Micro invasive squamous cell carcinoma (MISCC) comprises a significant portion of all cervical cancers in Slovenia. Criteria of carcinomatous invasion are well described in the literature, however histopathological assessment of MISCC is difficult, because morphological characteristics can overlap with cervical intraepithelial neoplasia grade 3 (CIN 3) and other pathological changes.

The aim of our study was to evaluate the reliability of the histopathological diagnosis of MISCC in Slovenia during the period from 2001 to 2007.

Materials and methods: Data on patients with a histopathological diagnosis of cervical MISCC (FIGO stage IA) in the period of 2001 to 2007 were obtained from the Cancer Registry of Slovenia. Histological slides were obtained from the majority of pathology laboratories in Slovenia. We received 250 cases (69% of all MISCC) for the review; 30 control cases were added to avoid bias. The slides were coded and reviewed.

Results: Among 250 cases originally diagnosed as MISCC, there was an agreement with MISCC diagnosis in 184 (73.6%) cases, 179 cases were FIGO stage IA1. Of these 117 showed early stromal invasion, (i.e. depth of invasion less than 1 mm), 64 (25.6%) cases were not diagnosed as MISCC, 2 (0.8 %) cases were invasive squamous cell carcinoma FIGO stage IB.

Conclusions: The retrospective review of cases diagnosed as MISCC during the period 2001- 2007 in Slovenia showed a considerable number of overdiagnosed cases. Amongst cases with MISCC confirmed on review, there was a significant proportion with early stromal invasion (depth of invasion less than 1 mm).