ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 PS-08-034 High-risk HPV screening - A retrospective study of a Portu- guese cervical cancer screening program R. Moiteiro da Cruz*, T. André Sousa Oliveira, J. Boavida, M. Pinho, C. Ferreira, D. López-Presa *Department of Pathology - Hospital de Santa Maria, CHULN; Faculdade de Medicina da Universidade de Lisboa, Portugal Background & objectives: Cervical cancer is the fourth most com- mon female malignancy. High-risk HPV molecular testing has been considered a useful screening option to identify women with cervical cancer. Herein, we aimed to correlate our institutional molecular results with the histological follow-up. Methods: A retrospective and unicentric study was conducted, regarding the cervical cancer screening program of the Lisbon and Tejo Valley region, between October 2017 and December 2019. Women with HPV16 and/or HPV18 infection were considered; patients infected with the former strains and by other high-risk strains were also included; their clinical data and biopsy diagnosis were collected. Results: From a total of 33567 high-risk HPV detection tests (cobas®), 3%(n=1138) were HPV16, and/or HPV18 posi- tive, with/without co-infection with other strains: HPV16 positive–43,32%(n=493), HPV18 positive–13,26%(n=151), HPV16&18 positive–0,96%(n=11), HPV16&18 and other high-risk strains–1,76%(n=20). About 78,6%(n=895) were evaluated by col- poscopy with posterior biopsy. From these, HPV16 group(n=399) was associated in 34,01%(n=136) with high-grade lesions [high- grade squamous intraepithelial lesion(HSIL)–95,59%(n=130); squamous cell carcinoma(SCC)–0,73%(n=1); adenocarcinoma(ADC) in situ-2,94%(n=4); ADC-0,73%(n=1)]; in HPV18 group(n=115), 6,56%(n=8) cases were associated with high-grade lesion (all HSIL). In HPV16/18 group(n=9), 77,78%(n=7) patients were asso- ciated with high-grade lesion (all HSIL). In the HPV16/18 with other high-risk strains group(n=13), 46,15%(n=6) cases were asso- ciated with high-grade lesions [HSIL-80%(n=5); ADC-20%(n=1)]. Conclusion: High-risk HPV molecular testing of our population has given us the opportunity to screen cervical cancer and to get the real incidence of HPV infection genotype 16 and 18. Despite the necessity of further studies to appreciate the specificity/sensi- bility of this test, namely considering patients infected with other high-risk strains besides 16 and 18, we conclude that patients with co-infection with various high-risk strains and HPV16 infection have the greatest association of high-grade lesions; HPV18 group is the least associated. PS-08-035 Disagreement in anatomopathological review reports in gynae- cological pathology and its impact on treatment: the impor- tance of the subspecialist pathologist in a cancer centre B. Maran, L. de Brot, M. Corassa, R. de Paula* *Ac Camargo Cancer Center, Brazil Background & objectives: The anatomopathological report is crucial for clinical decisions. In this context, reference cancer centres often review external reports to reduce errors and inappropriate therapies. This study aimed to assess the degree of disagreement in reviews of external reports in gynaecology. Methods: This is a single-centre, retrospective study, in which 219 cases of gynaecological pathology were reviewed between January 1, 2021 to December 31, 2021. The degree of disagreement was separated into “major” (when the discrepancy between the reports generated a change in the patient’s therapy), "minor" (when there was no impact on patient management) and "no change" (when there was agreement). Results: 219 cases were analysed. The median age of the popu- lation was 48 years. 201 cases were oncological and 18 cases were not related to cancer. Most of the cases represented primary gynaecological neoplasms (only 6 cases were from metastases or tissues outside the female genital tract). There was agreement (“no change”) in 70 cases (31.9%), "minor" disagreement in 107 cases (47.4%) and "major" disagreement in 42 cases (19.1%). When together, the major and minor disagreements correspond to 66.5% of the sample. The results were tabulated in tables and graphs. Conclusion: The data presented, although showing a reality of only one year, are consistent with the perspective that in pathology, and especially in gynaecological pathology, the analysis of cases by a subspecialist is essential for the proper management of the patient. That is fundamental not only to ensure the provision of adequate treatment for patients, but also to reduce the risk of morbidities associated with aggres- sive cancer therapies. PS-08-036 Ovary intraoperative consultation – are we doing the best we can? – A ten-year retrospective analysis of our experience C. Dahlstedt-Ferreira*, S. Carralas Antunes, R. Oliveira, D. Gomes Pinto *Hospital Garcia de Orta, E.P.E, Portugal Background & objectives: Ovarian tumours are frequently subjected to intra-operative consultation (IOC). These can be challenging cases and misdiagnoses are frequent[DGP1]. Our aim is to evaluate how our intraoperative diagnoses affected patient management in our institution to improve future performance. Methods: We identified all the ovarian tumours subjected to IOC over a period of 10 years (2012-2022), which required intraoperative examination, in our institution. We analysed the concordance between intraoperative and definitive diagnosis by means to evaluate how our intraoperative diagnosis affected patient management. The dataset was based on the patients’ pathology reports and clinical files. Results: In this period, we performed 81 IOCs for ovarian tumours. The average age of patients was 56 years. Sixty-one IOCs (76,3%) were concordant with the final diagnosis and twenty were dis- cordant (23,7%). Four discordant cases changed from benign to borderline; five from benign/borderline to malignant and five from borderline to benign tumour. Histological type of six of the malig- nant tumours was changed. Discordant cases were more frequent in serous tumours (n=7; p=1, not significative) and six were of the mucinous type. Conclusion: Intraoperative examination of ovarian masses is known to have a high accuracy and therefore provides some guidance to the surgeon’s conduct. It is also known to have many pitfalls posing a challenge to the pathologist. At our institution, the concordance between intraoperative diagnosis and definitive diagnosis is in line with the literature. Mucinous neoplasms pose a higher challenge compared to other histological types, although in our series we didn’t find significant differences between IOC diagnoses of serous and mucinous tumours. PS-08-037 Intra-operative consultation of endometrial cancer – are frozen sections better than gross inspection alone? – A single-centre retrospective series over seven years S115