Analysis of outcomes following loop electrosurgical excision and clinical features of patients with cervical high-grade squamous intraepithelial lesions with abnormal preoperative endocervical curettage

Feng, C.; Gu, Liyi; Wei, Yingting; Niu, Jiaxin; Yang, Haima; Hong, Zubei; Qiu, Lihua

doi:10.1186/s12957-023-03088-5

Cited by 4 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Feng's study showed that the detection rate of HSIL increased by 5% in patients who underwent colposcopy combined with ECC [37], and this detection rate increased with age [38]. At the same time, Feng's study confirmed that 2 years after the LEEP, the rate of recurrence in patients with ECC positivity was as high as 15.9% [37]. Our study revealed that ECC suggesting HSIL was an independent risk factor for uterine residual lesions.…”

Section: Discussionsupporting

confidence: 63%

“…According to current when colposcopy is inadequate, ECC can be considered for nonpregnant patients [36]. Feng's study showed that the detection rate of HSIL increased by 5% in patients who underwent colposcopy combined with ECC [37], and this detection rate increased with age [38]. At the same time, Feng's study confirmed that 2 years after the LEEP, the rate of recurrence in patients with ECC positivity was as high as 15.9% [37].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for residual lesions after total hysterectomy in patients with high-grade cervical intraepithelial neoplasia

Wang,

2024

BMC Women's Health

View full text Add to dashboard Cite

Background The purpose of this study was to predict the risk factors for residual lesions in patients with high-grade cervical intraepithelial neoplasia who underwent total hysterectomy. Methods This retrospective study included 212 patients with histologically confirmed high-grade cervical intraepithelial neoplasia (CIN2-3) who underwent hysterectomy within 6 months after loop electrosurgical excision procedure (LEEP). Clinical data (e.g., age, menopausal status, HPV type, and Liquid-based cytology test(LCT) type), as well as pathological data affiliated with endocervical curettage (ECC), colposcopy, LEEP and hysterectomy, were retrieved from medical records. A logistic regression model was applied to estimate the relationship between the variables and risk of residual lesions after hysterectomy. Results Overall, 75 (35.4%) patients had residual lesions after hysterectomy. Univariate analyses revealed that positive margin (p = 0.003), glandular involvement (p = 0.017), positive ECC (p < 0.01), HPV16/18 infection (p = 0.032) and vaginal intraepithelial neoplasia (VaIN) I-III (p = 0.014) were factors related to the presence of residual lesions after hysterectomy. Conversely, postmenopausal status, age ≥ 50 years, ≤ 30 days from LEEP to hysterectomy, and LCT type were not risk factors for residual lesions. A positive margin (p = 0.025) and positive ECC (HSIL) (p < 0.001) were identified as independent risk factors for residual lesions in multivariate analysis. Conclusions Our study revealed that positive incisal margins and ECC (≥ CIN2) were risk factors for residual lesions, while glandular involvement and VaIN were protective factors. In later clinical work, colposcopic pathology revealed that glandular involvement was associated with a reduced risk of residual uterine lesions. 60% of the patients with residual uterine lesions were menopausal patients, and all patients with carcinoma in situ in this study were menopausal patients. Therefore, total hysterectomy may be a better choice for treating CIN in menopausal patients with positive margins and positive ECC.

show abstract

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Risk factors for residual lesions after total hysterectomy in patients with high-grade cervical intraepithelial neoplasia

Wang,

2024

BMC Women's Health

View full text Add to dashboard Cite

show abstract

“…HPV infection has been confirmed by multiple studies as an important predictive indicator for residual CIN lesions ( 5 , 22 , 23 ). In this study, the post-LEEP follow-up HPV infection status was closely related to the presence of residual CIN3 lesions after LEEP, and it can serve as an independent predictive indicator for residual lesions in CIN3 patients undergoing LEEP.…”

Section: Discussionmentioning

confidence: 84%

“…Other way, we do not rule out the possibility that this could be caused by collinearity between the variables, as well as potential selection bias and a relatively short follow-up period (18). HPV infection has been confirmed by multiple studies as an important predictive indicator for residual CIN lesions (5,22,23). In this study, the post-LEEP follow-up HPV infection status was closely related to the presence of residual CIN3 lesions after LEEP, and it can serve as an independent predictive indicator for residual lesions in CIN3 patients undergoing LEEP.…”

Section: Discussionmentioning

confidence: 99%

A predictive model for residual lesions after LEEP surgery in CIN III patients

Deng,

Wang,

Chen

et al. 2023

Front. Med.

View full text Add to dashboard Cite

Background and aimsThe residual lesions after Loop Electrosurgical Excision Procedure (LEEP) contributes to poor prognosis in patients with Cervical Intraepithelial Neoplasia Grade 3 (CIN3). The aim of this study is to establish an effective clinical predictive model for residual lesions in CIN3 patients after LEEP.MethodsA retrospective analysis was performed on 436 CIN3 patients who underwent total hysterectomy within 3 months after LEEP. Based on the post-hysterectomy pathologic, the patients were divided into the no residual group and residual group. Clinical parameters were compared between the two groups, and univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for residual lesions in CIN3 patients after LEEP. Using R software, a nomogram model was established and its effectiveness was evaluated using calibration plots.ResultsThere were 178 cases in the residual group and 258 cases in the no residual group. The two groups had no significant difference in general characteristics (p > 0.05). It was found that Post-LEEP follow-up HPV, Post-LEEP follow-up TCT, and the Gland involvement were independent risk factors for residual lesions in CIN3 patients after LEEP (all p < 0.05). The consistency index (C-index) of the nomogram model for predicting residual lesions was 0.975 (0.962–0.988).ConclusionThe Post-LEEP follow-up HPV, Post-LEEP follow-up TCT, and Gland involvement are independent risk factors related to residual tissue after LEEP surgery in CIN3 patients. The constructed nomogram can effectively predict the presence of residual tissue after LEEP surgery in CIN3 patients and has good practical value.

show abstract

PAX1 methylation as a robust predictor: developing and validating a nomogram for assessing endocervical curettage (ECC) necessity in human papillomavirus16/18-positive women undergoing colposcopy

Lu,

Wu,

et al. 2024

Clin Epigenet

View full text Add to dashboard Cite

Objective The major challenge in routine endocervical curettage (ECC) among Human Papillomavirus (HPV) 16/18-positive patients is that only a small fraction benefit. Nevertheless, current reported models often overestimate the validity and necessity of ECC, making it difficult to improve benefits for patients. This research hypothesized that assessing paired boxed gene 1 methylation levels (PAX1m) and clinical characteristics could enhance the predictive accuracy of detecting additional high-grade squamous intraepithelial lesions or worse (HSIL +) through ECC that were not identified by colposcopy-directed biopsy (CDB). Methods Data from 134 women with HPV16/18 positivity undergoing CDB and ECC between April 2018 and April 2022 were collected and analyzed. Quantitative methylation-specific polymerase chain reaction (qMSP) was utilized to measure PAX1m, expressed as ΔCp. Univariate and multivariate regression analyses were conducted to screen variables and select predictive factors. A nomogram was constructed using multivariate logistic regression to predict additional HSIL + detected by ECC. The discrimination, calibration, and clinical utility of the nomogram were evaluated using receiver operating characteristic curves (ROC) and the calibration plot. Results Age (odds ratio [OR], 5.654; 95% confidence interval [CI], 1.131–37.700), cytology (OR, 24.978; 95% CI, 3.085–540.236), and PAX1 methylation levels by grade (PAX1m grade) (OR, 7.801; 95% CI, 1.548–44.828) were independent predictive factors for additional detection of HSIL + by ECC. In HPV16/18-positive women, the likelihood of additional detection of HSIL + through ECC increased with the severity of cytological abnormalities, peaking at 43.8% for high-grade cytological lesions. Moreover, when cytological findings indicated low-grade lesions, PAX1 methylation levels were positively correlated with the additional detection of HSIL + by ECC (P value < 0.001). A nomogram prediction model was developed (area under curve (AUC) = 0.946; 95% CI, 0.901–0.991), demonstrating high sensitivity (90.9%) and specificity (90.5%) at the optimal cutoff point of 107. Calibration analysis confirmed the model’s strong agreement between predicted and observed probabilities. Conclusion The clinical nomogram presented promising predictive performance for the additional detection of HSIL + through ECC among women with HPV16/18 infection. PAX1 methylation level could serve as a valuable tool in guiding individualized clinical decisions regarding ECC for patients with HPV 16/18 infection, particularly in cases of low-grade cytological findings.

show abstract

Analysis of outcomes following loop electrosurgical excision and clinical features of patients with cervical high-grade squamous intraepithelial lesions with abnormal preoperative endocervical curettage

Cited by 4 publications

References 28 publications

Risk factors for residual lesions after total hysterectomy in patients with high-grade cervical intraepithelial neoplasia

Risk factors for residual lesions after total hysterectomy in patients with high-grade cervical intraepithelial neoplasia

A predictive model for residual lesions after LEEP surgery in CIN III patients

PAX1 methylation as a robust predictor: developing and validating a nomogram for assessing endocervical curettage (ECC) necessity in human papillomavirus16/18-positive women undergoing colposcopy

Contact Info

Product

Resources

About