HCG observation of 2+ mitotic figures using phosphate histone H3 immunostaining in HSIL diagnosis

Abstract

The present study examined the usefulness of the criterion “two or more mitotic figures per 40× objective field of view (2+ mitotic figures)” for the accurate diagnosis of HSIL. Cervical cytology was conducted on 30 cases of HSIL and 40 of ASC-H. Histological classifications were as follows: 24 cases of CIN2 or more (CIN2+), 4 of CIN1, and 2 of squamous metaplasia in the former group, and 24 cases of CIN2+, 4 of CIN1, and 12 of squamous metaplasia in the latter group. In Pap specimens, five HCG clusters were randomly selected and examined to assess the frequency of 2+ mitotic figures. Pap specimens were then destained and subjected to anti-phosphohistone H3 (PHH3) immunocytochemistry (ICC). As a result, in cases of CIN2+, the frequency of 2+ mitotic figures was significantly higher (p < 0.001) in ICC (42.8%) than in Pap (median: 0%). Regarding CIN2+ in ASC-H, ICC (40.2%) was significantly higher (p < 0.001) than Pap (0%). In comparisons of lesions in ASC-H by ICC, CIN2+ (40.2%) was significantly higher (p = 0.048) than squamous metaplasia (5.0%). 2) Regarding the frequency of 2+ mitotic figures in ASC-H, CIN2+ (95.8%) was significantly higher (p = 0.003) than squamous metaplasia (50%). 3) In addition, the time for detection of 2+ mitotic figures was significantly shorter (p < 0.001) by ICC (8.1 sec) than by Pap (52.9 sec). In conclusion, the detection of 2+ mitotic figures in PHH3-ICC is useful for the diagnosis of HSIL.