Effect of endocervical glandular involvement on residual and recurrent disease in patients with high grade cervical dysplasia

Abstract

The aim of this study was to evaluate the effect of endocervical glandular involvement on residual and recurrent disease in high-grade cervical dysplasia. Material and Methods: Patients underwent Loop Electrosurgical Excision Procedure (LEEP) or Cold Knife Conization (CKC) between January 2015 and June 2016 were identified. Patients that had low grade lesions in conization specimens were excluded. The data were collected for age, menopausal status, cytology, colposcopic findings, conization procedure, HPV positivity and subtype, diameters of specimen, number of pieces, pathologic data including status of margins, endocervical glandular involvement (EGI) and recurrence. Prognostic effect of EGI on residual and recurrent disease were evaluated Results: Of 282 patients, 204 were eligible. Median age was 41 years in both groups. Age, menopausal status, cytology, diameters of specimen, number of pieces, colposcopy findings and conization procedure did not differ between groups.. Surgical margin positivity was higher in EGI positive group. HPV type 16 positivity was significantly higher in EGI positive patients. EGI was found to be the only prognostic factor for residual disease and was not a prognostic factor for recurrent disease. Conclusion: Our findings showed that EGI appears as a poor prognostic factor for residual disease but not for recurrence in patients with high-grade cervical dysplasia. Amaç: Bu çalışmanın amacı yüksek dereceli servikal displazide endoservikal gland tutulumunun rezidü ve recurrent hastalık üzerine etkisini araştırmaktır. Gereç ve Yöntem: Ocak 2015-Haziran 2016 tarihleri arasında loop electrosurgical excision procedure (LEEP) ya da soğuk konizasyon yapılan hastalar belirlendi. Konizasyon spesimeninde düşük dereceli displazisi bulunan olgular dışlandı. Yaş, menaposal durum, servikal sitoloji, kolposkopik bulgular, konizasyon işlemi, HPV pozitifliğ ve alt tipi, spesimen boyutları, endoservikal gland tutulumu, cerrahi sıırların durumu, ve rekürrens verileri hasta kayıtlarından elde edildi. Endoservikal gland tutulumunun rezidüel ve rekürren hastalık üzerindeki prognostic etkileri derğerlendirildi. Bulgular: 208 yüksek dereceli servikal displazisi bulunan olgudan 204'ü çalışmaya dahil edildi. Yaş, menaposal durum sitoloji, spesimen boyutları, çıkarılan parka sayısı, koloposkopik bulgular, ve konizasyon işlemi açısından gruplar arasında fark yoktu Cerrahi sınır pozitifliği gland tutulumu olan grupta daha fazlaydı. HPV 16 pozitifliği gland tutulumu olan grupta daha yüksek idi. Endoservikal gland tutulumu rezidü hastalık için prognostik faktör iken rekürrens için prognostic etksinin olmadğı bulundu. Sonuç: Çalışmamız endoservikal gland tutulumunun yüksek dereceli servikal displazide kötü prognostik faktör olduğu rekürrens için prognostik etkisinin olmadığı sonucuna varmıştır.

Is Endocervical Glandular Involvement Related to The Depth of Cone Biopsy?

“…Even though HPV-16 is reported to be significantly more common in patients with positive glandular involvement, HPV-16 was found to be the most common HPV genotype in cases with negative (65%) and positive (64.4%) endocervical glandular involvement, and there was no difference between the two groups in our study. 30 Also, the distribution of HPV-18 and other high-risk-HPV genotypes was not different between the two study groups. However, the percentages of HPV-16 in CIN 1, 2, and 3 patients were 44.8%, 66.7%, and 69.9%, respectively; moreover, the frequency of HPV-16 was significantly higher in the high-grade cervical dysplasia cohort.…”