Immunohistochemical expression of Ki 67 in low grade lesions of cervix diagnosed by colposcopy

The basic elements in the development of cancer including cervical cancer and its precursors are uncontrolled cell proliferation and malignant transformation. Precancerous lesions of cervix are easily detectable and treatable. Population based cervical screening with the help of Pap smear, colposcopic screening with biopsies and LLETZ procedure for treatment has substantially reduced the incidence of cervical cancer. Many a time low grade lesions diagnosed clinically does not correlate with morphology. Ki67 a proliferative index marker is a useful tool in identifying the proliferation of cells at an early stage. Hence this study aimed at finding out the utility of Ki67 a proliferative index marker in clinically discordant cases where the colposcopy diagnosis was LSIL and histopathology was chronic cervicitis with squamous metaplasia. In our study 834 cases reported as chronic cervicitis with squamous metaplasia over a period of 6months had a high proliferative index score with Ki67 indicating that around 23.5 of cases go unnoticed on routine light microscopy. This inference from our study stresses the importance of running a proliferative index marker on a routine basis in clinically suspected low grade lesions even in population based screening to reduce the cancer burden.