Endocervical glandular involvement, positive endocervical surgical margin and multicentricity are more often associated with high‐grade than low‐grade squamous intraepithelial lesion

Kır, Gözde; Karabulut, Murat; Topal, Cumhur Selçuk; Yılmaz, Mesut

doi:10.1111/j.1447-0756.2012.01847.x

Cited by 12 publications

(10 citation statements)

References 25 publications

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“…Endocervical glandular involvement was reported to be 4 times more common in high-grade CIN when compared with low-grade CIN [6]. Results of Kır et al [5] was similar to ours, 25% endocervical glandular involvement in CIN 1 and 91% endocervical glandular involvement in CIN 3. Previously reported studies related endocervical glandular involvement to higher recurrence after LEEP [2,[8][9][10][11][12].…”

Section: Discussionsupporting

confidence: 89%

“…Previously, another study designed similar to ours also reported higher multicentricity in high-grade CIN [5]. Other studies searched recurrence rates in multicentric lesions and related multicentircity to higher recurrence [2].…”

Section: Discussionmentioning

confidence: 62%

“…These patients are followed up with cytology and/or human papillomavirus-DNA, and an indication for intervention becomes acceptable only after a positive cytology biopsy result, but should we take the pathologic features of LEEP specimen into account? In this study, our aim is to compare the frequency of previously recommended risk factors for recurrence between lowgrade and high-grade CIN [5,6]. This may provide us risk factors for closer follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia

Güdücü

Sidar

Başsüllü

et al. 2013

Annals of Diagnostic Pathology

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia

Güdücü

Sidar

Başsüllü

et al. 2013

Annals of Diagnostic Pathology

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“…Kodampur et al, 16 in a cohort study of 309 women with highgrade CIN who underwent LEEP, confirmed the increased need for further intervention when there was endocervical glandular involvement (p ¼ 0.024), which is similar to our findings. Glandular involvement is closely related to HSIL, 17 and it was positively related to recurrence in the samples (p ¼ 0.019), which corroborates the findings of Güdücü et al, 18 who observed that glandular extension is more present in HG lesions, thus demanding greater care when monitoring these cases.…”

Section: Discussionsupporting

confidence: 86%

Evaluation of the p16 and Ki-67 Biomarkers as Predictors of the Recurrence of Premalignant Cervical Cancer Lesions after LEEP Conization

Leite

Tafuri

Costa³

et al. 2017

Rev Bras Ginecol Obstet

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Objective To evaluate the expressions of biomarkers p16 and K i -67 in low-grade (LG) or high-grade (HG) lesions, and to relate them to risk factors and the recurrence of these lesions. Methods A retrospective case-control study of 86 patients with LG and HG lesions who underwent a loop electrosurgical excision procedure (LEEP) between 1999 and 2004. The control group was composed of 69 women with no recurrence, and the study group, of 17 patients with recurrence. All patients were followed-up over a two-year period after surgery, and screened every six months, including cytology and colposcopy. Biopsy samples collected from LEEP were submitted to immunohistochemical analysis for p16 and K i -67. The statistical analysis was performed using the Statistical Package for the Social Sciences software (SPSS, IBM-SPSS, Inc., Chicago, IL, US), with a significant p < 0.05. Results The biomarkers p16 and K i -67, separately or combined, showed no relation to recurrence on the total analysis. However, evaluating specifically HG lesions, the positive expression (2þ and 3 þ ) of p16/K i -67 was associated with recurrence (0.010). In addition, p16 isolated was also more expressive in HG lesions (2þ and 3 þ , p ¼ 0.018), but it was unrelated to recurrence. Conclusion Proteins p16 and K i -67, both isolated and combined, are not reliable primary markers for the recurrence of cervical lesions in the majority of LG lesions. However, analyzing only the group with prior diagnosis of HG lesions, the expressions of p16 and of p16/K i -67 were associated with recurrence, and they may be useful in monitoring these cases. IntroductionThe search for markers to facilitate the diagnosis of diseases is a constant in scientific research to save resources, time and to prevent unnecessary treatments. Cervical cancer is the most common cancer among women in 45 countries of the world and, worldwide, 266 thousand women die of it each year; 1 it is preceded by cervical lesions that may or may not progress to invasion. They are associated with infection and with the persistence of the human papillomavirus (HPV) to progress to invasive carcinoma. 2 Through this process, the cells infected with high-risk oncogenic HPV alter the cell cycle, modifying the production of proteins p16 and K i -67. The most common treatment for high grade (HG) lesions is cervical cone resection using the loop electrosurgical excision procedure (LEEP). A major concern of the treatment is the recurrence of the lesion, as it may reappear without symptoms and more severely. Proteins p16 and K i -67 are, respectively, cell progression and proliferation markers. Protein p16 is a tumor suppressor from the Ink4a family that induces the hyperphosphorylation of the retinoblastoma protein (pRb), and has low expression in normal tissues.3 K i -67 is a nuclear protein present in cells during the active proliferation stage, but it is not expressed when cells are in the quiescent state. 3 The expression of both molecules simultaneously already denotes some problem in the cell c...

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“…Margin status (endocervical, ectocervical) were defined as positive based on the presence of AIS, invasive carcinoma or less than 1 mm at the edge of the specimens, or on the presence of CIN or less than 0.1 mm. Endocervical glandular involvement was defined as dysplastic squamous epithelium occupying well-circumscribed, rounded spaces in the depth of the cervical stroma 20 .…”

Section: Methodsmentioning

confidence: 99%

The effects of different instruments and suture methods of conization for cervical lesions

Wang

et al. 2019

Sci Rep

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This study is to compare the surgical outcomes of patients undergoing cold knife conization (CKC) versus electrosurgical conization (ESC). Among 10,086 patients in a single center admitted between January 2000 and January 2019, CKS or ESC was used for grade 3 cervical intraepithelial neoplasia (CIN3) or more severe lesions. Modified Sturmdorf or Figure-of-eight sutures were applied after conization. A regression model was used to determine the risk factors for margin involvement and short-term post-operative complications. In total, 7275 (72.1%) and 2811 (27.9%) patients underwent CKC and ESC, respectively. Women who underwent ESC were older and had a higher risk of margin involvement and endocervical glandular involvement than those who underwent CKC in univariate analysis. However, in the multivariate analysis, age (odds ratio [OR] 1.032, 95% confidence interval [95% CI] 1.025–1.038) and glandular involvement (OR 2.196, 95% CI 1.915–2.517) were the independent risk factors associated with margin involvement, but the incision methods used caused no significant difference. Modified Sturmdorf sutures and Figure-of-eight sutures were applied in 3520 (34.9%) and 6566 (65.1%) patients, respectively. The modified Sturmdorf sutures was the only risk factor associated with wound hemorrhage (OR 1.852, 95% CI 1.111–3.085) after adjusted with other epidemiological and surgical factors. Various incision or suture methods had similar risk of cervical stenosis. Therefore, ESC is an acceptable alternative to CKC for the diagnosis and treatment of cervical lesions regarding the pathologic accuracy and integrity, and short-term safety. Modified Sturmdorf sutures increased the risk of wound hemorrhage compared with Figure-of-eight sutures.

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Endocervical glandular involvement, positive endocervical surgical margin and multicentricity are more often associated with high‐grade than low‐grade squamous intraepithelial lesion

Cited by 12 publications

References 25 publications

Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia

Endocervical glandular involvement, multicentricity, and extent of the disease are features of high-grade cervical intraepithelial neoplasia

Evaluation of the p16 and Ki-67 Biomarkers as Predictors of the Recurrence of Premalignant Cervical Cancer Lesions after LEEP Conization

The effects of different instruments and suture methods of conization for cervical lesions

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