Study On Morphological Features And Proliferation And Differentiation Characteristics Of Atypical Immature Metaplasia Of Cervix

Object: We aimed at investigating the characteristics of atypical immature metaplasia (AIM) of cervix and the potential diagnosis and differential diagnosis of this disease based on histopathologic features, residual mucus, proliferative rate, cell differentiation, and high-risk HPV infection.Methods: 55 cases of originally diagnosed cervical interepithelia neoplasia grade II(ICINIII) and 14 cases of ordinary squamous metaplasia of cervical polyps (OSM) were used to perform the study. Histopathological features were observed in these samples. The state of mucous residual and the degree of cell proliferation and differentiation were detected by pathomorphism review, Alcian-Blue stain and immunohistochemical staining of Ki-67 , keratin 10,14,19. High-grade HPV (HPV16) infection of those cases were also detected by semi-nested PCR methods.Results: (1) One case of CINⅢwas re-diagnosed as AIM based on Crum's diagnostic histology standard; (2) According to the state of mucous residual in squamous epithelium,7 out of 55 cases of CINIII were diagnosed as AIM; (3) the Ki-67 expression in AIM was significantly higher than that of OSM(P=0.022), but much lower than that of CINIII (P=0.022; P=0.000); (4) the difference of the expression of keratin 10 in AIM and CINIII is significant (P=0.000);but the expression of keratin 14 and 19 have no significant differences between AIM and CINIII groups(P=1.000;P=0.240); (5)the infection rate of HPV16 has no significant difference between AIM (71.4%) and CINIII (85.5%) (P=0.321).Conclusion: (1) In this study, based on Crum's diagnostic standard, we used multi-methodologies put forward the integrative diagnostic bases of AIM for the first time:①mitosis≤1/10HP,at the lower 1/3 layers of epithelium;②pathological karyokinesis is rare;③AB stain shows residual mucus;④Ki-67 PI is 31.87±18.85;⑤KT10 is strongly expressing in each layer of epithelium except basal and sub-basal layers.; (2) We demonstrate that AIM is probably a low-grade intraepithelial lesion of the cervix and associated with high-grade HPV infection.