Risk Factors of Preterm Birth in Women After Local Treatment of Cervical Intraepithelial Neoplasia – a Retrospective Cohort Study

Stubert, Johannes; Stratmann, Elisa; Gerber, Bernd; Mann, Ellen

doi:10.1055/a-1909-0735

Cited by 3 publications

(3 citation statements)

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“…In these young women and in those with CIN 1 and CIN 2 with an existing desire to have children, the harm would be great if the overtreatment increased the incidence of premature births [25]. It should be noted that especially in women < 30 years, the risk of preterm birth after conization seems to be high [26].…”

Section: Discussionmentioning

confidence: 99%

“…Bei diesen jungen Frauen und bei denen mit einer CIN 1 und CIN 2 bei bestehendem Kinderwunsch wäre der Schaden groß, wenn als Folge einer Übertherapie in Kauf genommen wird, die Inzidenz der Frühgeburtlichkeit zu erhöhen 2525 . Es ist zu beachten, dass insbesondere bei Frauen < 30 Jahren das Frühgeburtsrisiko nach Konisation hoch zu sein scheint 2626 .…”

Section: Diskussionunclassified

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Registry Study of the Working Group on Cervical Pathology and Colposcopy (AGCPC) on the Diagnostic Algorithm for the New Cervical Cancer Screening – Initial Data

Henes,

Mann,

Hirchenhain

et al. 2023

Geburtshilfe Frauenheilkd

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For the first time since 1971, new regulations were introduced for cervical cancer screening as an organized cancer screening guideline (oKFE-RL) starting 1 January 2020. From the age of 20, a cytological smear test is performed annually, and from the age of 35, so-called co-testing (cytology and test for high-risk HPVs) is performed every three years. In case of abnormalities, the algorithm is used as the basis for investigation. According to this diagnostic algorithm, even so-called low-risk groups receive early colposcopic evaluation. This approach has been heavily debated and serves as the basis for this registry study.All patients who presented to the centers for a colposcopy as part of the diagnostic algorithm were included after signing an informed consent form. The following findings were obtained: Medical history, colposcopy, histology, and cytology findings, as well as possible therapies and their findings. The aim was to evaluate the frequency of the target lesions cervical intraepithelial neoplasia (CIN) 2+/CIN 3+ in the respective groups.A total of 4763 patients were enrolled in the study from July 2020 to October 2022. As a referral diagnosis, HPV persistence (HPV: human papillomavirus) with group I was determined in 23.9% (1139), HPV persistence with group II-a in 2.1% (100), II-p (ASC-US) in 11.2% (535), and II-g (AGC endocervical NOS) in 1.3% (64). III-p (ASC-H) and III-g (AGC endocervical favor neoplastic) were found in 9.4% (447) and 2.2% (107), respectively, IIID1 (LSIL) in 19% (906), IIID2 (HSIL, moderate dysplasia) in 18.9% (898), IVa-p (HSIL, severe dysplasia) in 10.7% (508), IVa-g (AIS) in 0.7% (31), IVb-p (HSIL with features suspicious for invasion) and IVb-g (AIS with features suspicious for invasion) in 0.3% (15), 0.1% (6), and 7 with suspected invasion V-p (squamous cell carcinoma)/V-g (endocervical adenocarcinoma) (0.1%). In the IVa-p group (HSIL, severe dysplasia), 67.7% had CIN 2+ and 56.5% had CIN 3+, adenocarcinoma in situ (AIS), and adenocarcinoma. If the histology of the excised tissue specifically based on the colposcope findings was also evaluated, CIN 2+ was found in 79.7% of cases, and CIN 3+ in 67.3% of cases. In IIID2 (HSIL, moderate dysplasia), CIN 2+ was detected in 50.9%, and CIN 3+/AIS in 28.3%. After evaluating patients who underwent surgery immediately, this increased to 53.0% for CIN 2+ and 29.3% for CIN 3+/AIS. In IIID1 (LSIL), CIN 2+ was detected in 27.4% and CIN 3+/AIS in 11.7%, and in II-p (ASC-US), CIN 2+ was detected in 23.4% and CIN 3+ and AIS in 10.8%, and in II-g (AGC endocervical NOS), CIN 2+ was detected in 34.4% and CIN 3+ in 23.4%. In the HPV persistence/II-a and I group, 21% showed CIN 2+, and 12.1% showed CIN 3+ and AIS, and 13% showed CIN 2+ and 5.9% showed CIN 3+ and AIS. In patients who were HPV-negative and had further diagnostics performed on the basis of cytologic smear alone, 27.9% had CIN 2+, and 14.1% had CIN 3 and AIS.In a synopsis of the present findings of our initial data of the registry study on the new cervical cancer screening, according to the organized early cancer screening guideline (oKFE-RL), we could show that the target lesion CIN 3+ and AIS is detected unexpectedly frequently in a not insignificant proportion, especially in the cytological low-risk group. Currently, we cannot answer whether this can reduce the incidence and mortality of cervical carcinoma, but this could be an initial indication of this and will be reviewed in further long-term evaluations.

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Section: Discussionmentioning

confidence: 99%

Section: Diskussionunclassified

Registry Study of the Working Group on Cervical Pathology and Colposcopy (AGCPC) on the Diagnostic Algorithm for the New Cervical Cancer Screening – Initial Data

Henes,

Mann,

Hirchenhain

et al. 2023

Geburtshilfe Frauenheilkd

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“…Increased risk is depending on the repeated intervention and the depth of the surgical excision. 5 According to conducted studies, women with untreated cervical intraepithelial neoplasia have alsoan increased risk of preterm birth and adverse obstetrical outcomes comparing to general population. 6 However, most essential entity, consists the recurrence avoidance of cervical lesions through proper follow up.…”

Section: Discussionmentioning

confidence: 99%

Juvenile high grade squamous intraepithelial lesion (HGSIL): A rare case

Chrisostomos,

Ioulia,

Spyridoula

et al. 2023

OGIJ

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Human papillomavirus (HPV)infection consists the majority of cervical precancerous lesions and cancers. Various screening programmes aim in indentifying HPV infection and preventing cervical cancer. We present a 20-year-old female patient whose first pap smear revealed atypical squamous cells of undetermined significance (ASCUS). Pap smear, followed by genotyping evaluation, revealed high-risk HPV 33 infiltration. Colposcopy and cervical biopsies were performed due to suspicious cervical lesions, revealing cervical intraepithelial neoplasia grade II and focal high grade squamous intraepithelial lesion.(Grade III.) Patient underwentloop electrosurgical excision procedure (LEEP) due to assiduous imaging findings. Histopathologic establishment revealed anatomic areas of CIN III. (Cervical Intraepithelial Neoplasia) Aim of our study represents proper diagnosis and therapeutic mapping of a juvenile high grade cervical intraepithelial lesion, depending always on fertility preservation.

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