Mast Cell Density Across Non-neoplastic, Premalignant, and Malignant Cervical Lesions: A Prospective Observational Histopathological Study

Background: Mast cells participate in inflammation, tissue remodeling, angiogenesis, and tumor-stroma interactions, but their density across cervical lesions has been reported inconsistently.This study compared mast cell counts across non-neoplastic, premalignant, and malignant cervical lesions using 1% toluidine blue.Materials and methods: In this prospective observational study, 160 consecutive cervical specimens were examined at Gandhi Medical College, Bhopal, India.Diagnoses were established on hematoxylin and eosinstained sections.Mast cells were counted in 10 consecutive high-power fields incorporating areas of maximum concentration by three observers blinded to diagnosis; consensus counts were analyzed.The groups comprised 100 non-neoplastic, 18 premalignant, and 42 malignant lesions.Comparisons used Kruskal-Wallis tests and Holm-adjusted pairwise Mann-Whitney U tests.Results: Mean counts per 10 high-power fields were 94.7 ± 21.0, 64.3 ± 18.5, and 22.5 ± 7.0 in the nonneoplastic, premalignant, and malignant groups, respectively (Kruskal-Wallis H = 103.92;degrees of freedom = 2; p < 0.001; eta-squared based on H = 0.649).All pairwise comparisons were significant after Holm correction (p < 0.001).Chronic cervicitis had the highest mean count (98.6 ± 20.7).The non-neoplastic group comprised 76 chronic cervicitis cases, 21 polyps, and only three normal/unremarkable specimens.Wholecohort inverse correlations with age and parity were not statistically significant within the individual disease groups.Conclusions: Mast cell counts were lower in malignant than in non-neoplastic and premalignant cervical lesions in this cohort.The inflammatory and polypoid composition of the comparator group and the crosssectional comparison limit causal, temporal, and diagnostic interpretation.Standardized sampling, immunohistochemical confirmation, and external validation are needed before clinical application.