Absence of dysplasia in the excised cervix by a loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

Ryu, Aeli; Nam, Kae Hyun; Chung, Soo‐Ho; Kim, Jeong-Sik; Lee, Hae‐Hyeog; Koh, Eun Suk; Bae, Dong Han

doi:10.3802/jgo.2010.21.2.87

Cited by 47 publications

(53 citation statements)

References 21 publications

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“…This percentage is similar to other studies: 13.8% in the study by Livasy et al [9], 17.7% in the series by Ryu et al [10], 16% in the series by Rodriguez-Manfredi et al [11], 10% in the study by Witt et al [12], 17% by Carrig et al [13], and 18.2% in the study of Nam et al [16].…”

Section: Discussionsupporting

confidence: 79%

“…According to previous studies by Ryu et al [10], Rodriguez-Manfred et al Open Journal of Obstetrics and Gynecology [11], and Nam et al [16], a low viral load was related to the absence of dysplasia in cone specimens. In our institution, viral load readings before the cone biopsy were not available.…”

Section: Discussionmentioning

confidence: 99%

“…In the series by Ryu et al, only low HPV load was significantly associated with the probability of absence of a lesion in the conization specimen [10].…”

Section: Discussionmentioning

confidence: 99%

“…First, the CIN is removed completely during the biopsy because it is small [10]. In the study by Rodriguez-Manfredi [11], patients with lesions involving less than one quadrant of the cervix had an increased probability of having a white cone biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…Third, a pathologist may not have been capable of observing the area of the lesion [10], especially if they are not experienced pathologists. Finally, CINs are missed and not removed by LEEP [10]; this possibility is very unlikely because conization must include the transformation zone, and all lesions are located in this area [11].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Negative Cone Biopsies and Its Clinical Significance

Santana¹,

Baro²

2017

OJOG

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Objective: To determine the predictors of absence of lesion on cone biopsy (white cone). We evaluated several factors including parity, cytology, human papillomavirus (HPV) typing, biopsy, colposcopy, smoking habit, use of oral contraceptive or condom, and immunosuppression as predictors for absence of dysplasia. Methods: Of 510 patients with CIN (cervical intraepithelial neoplasia) treated by loop electrosurgical excision (LEEP) in the Fundación Jimenez Diaz hospital between 2012 and 2016, 51 (10%) patients had a white cone and were defined as the study group. The control group was established from two randomly selected controls for each case (n = 102). Results: The study group had a higher prevalence of low-grade cytology (p < 0.001), minor changes (p < 0.01), and CIN 2 (<0.001) than the control group. The study group had a lower rate of oral contraceptive use (p = 0.005), as demonstrated by the multivariate analysis (except for low-grade cytology). Conclusions: In conclusion, this study indicates that the incidence of white cone in our institution is 10% of all the cone biopsy and women with low-risk cytology, minor changes in colposcopy, CIN 2, and no use of oral contraceptive have a high probability of having no lesions in the conization specimen.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

“…In the series by Ryu et al, only low HPV load was significantly associated with the probability of absence of a lesion in the conization specimen [10].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predictors of Negative Cone Biopsies and Its Clinical Significance

Santana¹,

Baro²

2017

OJOG

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Evaluation of p16/Ki‐67 dual‐stain as triage test for high‐risk HPV‐positive women: A hospital‐based cross‐sectional study

Chen¹,

Chen

Liu

et al. 2022

Cancer Cytopathology

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BACKGROUND: Most human papillomavirus (HPV)-positive women recover from infections and do not develop cervical intraepithelial neoplasia (CIN) and cervical cancer. Additional triage approaches are needed to reduce unnecessary colposcopy referrals. The aim of this study is to determine the high-risk HPV prevalence in a hospital-based population and to evaluate the performance of p16/Ki-67 dual-stain test for the triage of high-risk HPV-positive women to detect precursor lesions and cervical cancer compared with the ThinPrep cytologic test (TCT). METHODS: In a hospital-based population, 100,801 women were provided with a primary HPV DNA test and only women with high-risk HPV infections were triaged using TCT and p16/Ki-67 dual-stain test. CIN2 or worse (≥CIN2) or CIN3 or worse (≥CIN3) were defined as the clinical end points. RESULTS: The p16/ Ki-67 dual-stain indicated a statistically significant higher sensitivity (82.8% vs. 66.7%%), specificity (51.6% vs. 44.4%), positive predictive value (33.2% vs. 25.8%), negative predictive value (91.2% vs. 82.1%), and accuracy (58.6% vs. 49.4%) compared with TCT examination within ≥CIN2 cases. Similar patterns were observed for the ≥CIN3 end point. CONCLUSIONS: Our study demonstrated that p16/Ki-67 dual-stain test could achieve better performance compared with TCT examination for ≥CIN2 or ≥ CIN3 detection, representing a promising approach as a specific and efficient triage strategy for high-risk HPV-positive women.

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Distribution of cervical intraepithelial neoplasia is closely associated with HPV status and uterine position

Tamura¹,

Sako

Watanabe³

et al. 2023

Journal of Medical Virology

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Although cervical intraepithelial neoplasia (CIN) lesions are considered to be not randomly distributed across the cervix, but predominantly in the anterior wall, the clinicopathological etiology remains unknown. Herein, we aimed to elucidate the relationship between quantitatively measured area of CIN2/3 and cervical cancer associated factors by retrospective cohort study. We analyzed 235 consecutive therapeutic conization specimens dissected as a single intact section to determine CIN2/3 area and its correlation with both clinical risk factors including human papillomavirus (HPV) status (single or multiple infection) and uterine position defined by transvaginal ultrasound. Cervical wall was classified into three groups: anterior: (11, 12, 1, and 2 o'clock), posterior (5, 6, 7, and 8 o'clock) and lateral (3, 4, 9, and 10 o'clock). Multiple regression revealed that younger age and HPV16 status were significantly correlated with CIN2/3 area (p = 0.0224 and p = 0.0075, respectively).The Jonckheere-Terpstra test showed a significant trend: CIN2/3 area was highest in the single HPV16 group, followed by the multiple HPV16 group and the non-HPV16 group (p < 0.0001). CIN2/3 area in the anterior wall was statistically significantly larger than the posterior and lateral wall (p = 0.0059 and p = 0.0107, respectively). CIN2/3 area in the anterior wall was significantly greater with anteversion-anteflexion than retroversion-retroflexion (p = 0.0485), whereas CIN2/3 area in the posterior wall was significantly larger with retroversion-retroflexion than anteversion-anteflexion (p = 0.0394). In conclusion, the topographical distribution of CIN2/3 area is closely associated with patient age, high-risk HPV status, especially single HPV16 infection and uterine position.

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Absence of dysplasia in the excised cervix by a loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

Cited by 47 publications

References 21 publications

Predictors of Negative Cone Biopsies and Its Clinical Significance

Predictors of Negative Cone Biopsies and Its Clinical Significance

Evaluation of p16/Ki‐67 dual‐stain as triage test for high‐risk HPV‐positive women: A hospital‐based cross‐sectional study

Distribution of cervical intraepithelial neoplasia is closely associated with HPV status and uterine position

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