Prevalence of Low-Grade and High-Grade Squamous Intraepithelial Lesions in Cervical Biopsies

Background: Squamous intraepithelial lesions (SIL) of the cervix represent premalignant epithelial abnormalities strongly associated with persistent high-risk human papillomavirus (HPV) infection. Based on the Bethesda system and WHO classification, cervical squamous intraepithelial lesions are categorized into low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL). Early detection and accurate histopathological grading of these lesions are essential for preventing progression to invasive cervical carcinoma. The aim is to determine the prevalence and histopathological spectrum of LSIL and HSIL in cervical biopsy specimens and to evaluate associated demographic and clinical factors. Material and Methods: This hospital-based observational cross-sectional study was conducted in the Department of Pathology, Acharya Shri Chander College of Medical Sciences and Hospital (ASCOMS), Jammu, over a period of one year. A total of 100 cervical biopsy specimens from women with clinically suspected cervical lesions were included in the study. Histopathological examination was performed for diagnosis and classification of lesions into LSIL and HSIL according to WHO/Bethesda criteria. Data were analyzed using SPSS version 27.0 and GraphPad Prism version 5. Statistical significance was considered at p<0.05. Results: The majority of patients belonged to the 41–50 years age group (34%). LSIL was the most common lesion observed in 46% cases, while HSIL accounted for 54% cases. Multiparity showed a significant association with increasing severity of cervical squamous intraepithelial lesions. White discharge per vaginum was the most common presenting symptom (38%). HPV positivity was observed in 76% cases and showed a significant association with HSIL lesions (p=0.001). Conclusion: Squamous intraepithelial lesions of the cervix are common among middle-aged women and are strongly associated with persistent HPV infection and multiparity. Histopathological evaluation of cervical biopsy specimens plays a crucial role in early diagnosis, accurate grading, and timely management of premalignant cervical lesions, thereby reducing the burden of invasive cervical carcinoma.

Keywords: LSIL, HSIL, Squamous intraepithelial lesion, Cervical biopsy, Human papillomavirus, Cervical dysplasia, Histopathology, Cervical cancer screening.