Of the patients who were diagnosed with CIN1 and monitored by colposcopy for 60 months, 34% had disease regression, 55% had persistent disease, and 11% had progressive disease. HPV DNA testing is more informative than the Pap test in the prediction of disease progression.
determined significance (ASCUS), low-grade squamous intraepithelial lesion (LGSIL), and high-grade squamous intraepithelial lesion (HGSIL) [1]. About 30% of highgrade lesions of the uterine cervix progress to invasive cancer [2], so when HGSIL is diagnosed, the cytologic diagnosis of CIN2 or CIN3, the disease should be evaluated histopathologically and treated thoroughly. On the other hand, LGSIL, the cytologic nomenclature koilocytotic atypia (which is analogous to CIN1), is usually managed by periodic follow-up. The earlier studies on the natural history of minor lesions encompassing CIN1 showed differing results owing to the kind of follow-up method used (i.e., biopsy on every visit) and the diagnostic tools such as Pap smear and/or biopsy. The consequence is that we still do not have a consenting protocol for the management of CIN1. This study was undertaken to elucidate the natural history of LGSIL and to suggest the triage of the patients with LGSIL.
AbstractObjective. To determine guidelines for management of CIN1 by evaluating its natural history.Methods. One hundred fifty-eight patients were diagnosed with CIN1 had colposcopy follow-up with or without cytology every three months.Results. Colposcopically directed biopsy confirmed progression to CIN2 or CIN3 in 17 of 158 (10.7%) patients, persistence of CIN1 in 87 (55%) patients, regression to normal in 54 (34.2%) patients during the 5-year follow-up period. The percentage of abnormal Pap tests were 39%, 64%, and 71% in the regression, persistent, and progression groups, respectively. The percentage of HPV-positive tests were 16%, 29%, 65% in regression, persistent, and progression groups, respectively.Conclusions. Of the patients who were diagnosed with CIN1 and monitored by colposcopy for 60 months, 34% had disease regression, 55% had persistent disease, and 11% had progressive disease. HPV DNA testing is more informative than the Pap test in the prediction of disease progression.
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