Persistent and recurrent cervical dysplasia after loop electrosurgical excision procedure

Brockmeyer, Amy; Wright, Jason D.; Gao, Feng; Powell, Matthew A.

doi:10.1016/j.ajog.2004.12.044

Cited by 41 publications

(36 citation statements)

References 6 publications

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“…8 For HPV genotyping, a commercial HPV DNA chip (MyHPV Chip) was used. The HPV chip can detect 24 type-specific HPVs (16,18,31,33,35,39,45, 51, 52, 53, 54, 56, 58, 59, 66, and 68) and eight of the low-risk group (6,11,34,40,42,43,44, and 70). Target HPV DNA was amplified by PCR with primers (HPV and human β-globulin) and conditions provided by Mygene (Seoul, Korea), and labeled using Cy5-deoxyuridine triphosphate (NEM Life Science Products, Boston, MA, USA).…”

Section: Detection Of Hpvmentioning

confidence: 99%

“…Specifically, age, cytological grade, menopausal status, resection margin involvement, and HPV load are all risk factors for recurrent disease after CIN treatment. 6,7 The aim of this study was to establish the rate of absence of dysplasia in LEEP specimens after treatment of CIN 2/3, and the predictive factors involved. In addition to the prediction of no dysplastic lesion, the impact on recurrence was analyzed by comparing other factors, including age, preoperative cytology, punch biopsy grade, HPV status, and margin involvement.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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Objective: Absence of dysplasia in the excised specimen following loop electrosurgical excision procedure (LEEP) for treatment of cervical intraepithelial neoplasia (CIN) 2/3 is an occasional finding of uncertain clinical significance. We evaluated several factors including age, liquid-based Pap (LBP) test, human papillomavirus (HPV) load before treatment, and HPV typing as predictors for absence of dysplasia. Absence of dysplasia in LEEP specimens was analyzed in terms of factors for recurrent disease after LEEP conization. Methods: In total, 192 women (mean age, 39.3±8.4 years; range, 24 to 70 years) with biopsy-proven CIN 2/3 were treated by LEEP conization. Age, LBP test, histological grade, HPV load, and HPV DNA typing were evaluated as possible predictors of the absence of residual dysplasia or recurrent disease. Results: Of the LEEP specimens, 34 (17.7%) showed no dysplasia in preoperative biopsies from patients with proven CIN 2/3. Low HPV load (＜100 relative light units [RLU]) was significantly related to the absence of dysplasia in LEEP specimens, using logistic regression. Margin involvement and high HPV load (≥400 RLU) were significant factors for recurrence. Conclusion: Absence of dysplasia in LEEP specimens occurred in 17.7% of our specimens. Prediction of the absence of dysplasia in LEEP specimens was associated with low HPV load. Residual/recurrent disease after LEEP was associated with a positive resection margin and high viral load, and was not associated with absence of dysplasia in LEEP specimens. Even if there is no dysplasia in conization specimens, close follow-up for residual/recurrent disease is needed.

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Section: Detection Of Hpvmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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“…La principal indicación de conización en nuestra casuística fue NIE de alto grado con 75,2% de los casos, siendo la principal indicación el CIS de cuello uterino en el 53 % de los casos, similar a lo presentado en otras publicaciones (2,3,4,5). En el 87 % de los casos con diagnóstico de CIS previo se comprueba lesión de alto grado (6).…”

Section: Discussionunclassified

Operación Cono Mediante Asa Electroquirúrgica (Leep) en El Hospital Regional De Copiapó: Análisis Del Período 1994-1999, Con Seguimiento Por 5 Años Hasta 2004

P¹,

R²,

et al. 2006

Rev. chil. obstet. ginecol.

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“…Essa técnica é considerada efi caz no diagnóstico e tratamento dessas lesões, sem prejuízo para diagnóstico, tratamento e recorrência, comparada à cirurgia convencional 2 . Apesar da efi cácia desse método, o seguimento pós-conização revela índices de recidiva que variam de 5 a 64% 3 . Os fatores de risco associados à recidiva das lesões intra-epiteliais cervicais são, geralmente: as margens cirúrgicas, o envolvimento glandular e o número de mitoses 4 .…”

Section: Introductionunclassified

Fatores de risco de recidiva de lesões intra-epiteliais cervicais após conização por cirurgia de alta freqüência em mulheres portadoras e não portadoras do vírus da imunodeficiência humana

Lima¹,

Melo²,

Tafuri³

et al. 2006

Rev. Bras. Ginecol. Obstet.

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Fatores de risco de recidiva de lesões intra-epiteliais cervicais após conização por cirurgia de alta freqüência em mulheres portadoras e não portadoras do vírus da imunodefi ciência humanaRisk factors for cervical intraepithelial lesions after loop electrosurgical excision procedure in HIV-infected and non-infected women Objetivos: avaliar os fatores de risco associados à recidiva das lesões intra-epiteliais, após conização do colo com cirurgia de alta freqüência. Métodos: estudo caso-controle aninhado em coorte de 201 pacientes que se submeteram à conização com cirurgia de alta freqüência por apresentarem lesão intra-epitelial cervical, acompanhadas, em média, por dois anos. Participaram 94 portadoras do HIV e 107 não-portadoras do vírus. A conização cervical foi realizada por cirurgia de alta freqüência e a peça cirúrgica encaminhada para exame histopatológico, que avaliou o grau da lesão, as margens e a ocupação glandular. Após a cirurgia, as pacientes foram examinadas a cada seis meses com citologia oncótica e colposcopia. Foram consideradas recidivas as lesões que, após a cirurgia, foram confi rmadas novamente por biópsia. Neste estudo, foram considerados casos as pacientes com recidiva e controles as sem recidiva. As comparações entre os grupos foram realizadas pelo teste do χ 2 e a análise multivariada pela regressão logística. Para a análise de sobrevida foi utilizado o método de Kaplan-Meier (teste log-rank). Resultados: houve recidiva das lesões em 40 pacientes. As variáveis que inicialmente apresentaram signifi cância estatística foram: número de parceiros, soropositividade, margens do cone e envolvimento glandular, como indicadores do risco para recidiva. A ocorrência simultânea de ocupação glandular e margens comprometidas apresentou as recidivas mais freqüentes. Após análise pela regressão logística, permaneceram signifi cativamente associados à recorrência das lesões: ocupação glandular (OR=9,1; IC a 95%:13,0-27,5); presença do HIV (OR=4,6; IC a 95%:1,1-6,3); margens comprometidas (OR-2,6; IC a 95%:1,9-11,2). Conclusões: os fatores de risco associados à recidiva das lesões intra-epiteliais cervicais foram: soropositividade, ocupação glandular e margens comprometidas. PALAVRAS-CHAVE:Neoplasia intra-epitelial cervical; Conização; Infecções por HIV; Recidiva local de neoplasia; Displasia do colo do útero Abstract Purpose: to evaluate risk factors associated with cervical intraepithelial lesion recurrence after LEEP conization. Methods: nested case-control study in a cohort of 201 patients with cervical intraepithelial lesion, that were submitted to LEEP conization. Average follow-up of these patients was 2 years. Ninety-four HIV-infected women and 107 non-infected were enrolled. Cervical conization was achieved by the Loop Electrosurgical Excision Procedure (LEEP). Evaluated surgical biopsy histopathological characteristics were lesion grade, lesion borders and glandular involvement. After surgery all patients were submitted to a colposcopy and cytological evaluation every six months. Recurrent lesi...

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Persistent and recurrent cervical dysplasia after loop electrosurgical excision procedure

Cited by 41 publications

References 6 publications

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

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

Operación Cono Mediante Asa Electroquirúrgica (Leep) en El Hospital Regional De Copiapó: Análisis Del Período 1994-1999, Con Seguimiento Por 5 Años Hasta 2004

Fatores de risco de recidiva de lesões intra-epiteliais cervicais após conização por cirurgia de alta freqüência em mulheres portadoras e não portadoras do vírus da imunodeficiência humana

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