“Equivocal” High-Risk HPV DNA Tests Performed on ThinPrep Specimens After ASC-US Diagnoses Are Associated With an Increased Incidence of CIN3

HooKim, Kim; Lieberman, Richard W.; Smola, Brian; Knoepp, Stewart M.

doi:10.1097/lgt.0000000000000018

Cited by 1 publication

(1 citation statement)

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“…Twenty-four patients (38%) had a diagnosis of atypical glandular cells on their Pap smear before their AIS diagnosis. More than half of the patients (60%, 52 of 87) were known HPV positive, 1 (1%) was known HPV negative, 33 (40%) were HPV unknown, 17 and 1 (1%) was HPV equivocal. The HPV DNA testing started at our institution in 2004 with Hybrid Capture 2, an enzyme immunoassay.…”

Section: Resultsmentioning

confidence: 99%

Fertility and Pregnancy Outcomes After Conservative Management of Adenocarcinoma In Situ of the Cervix

Bell

Peng

Kobernik

et al. 2021

J Low Genit Tract Dis

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ObjectiveThe aim of the study was to evaluate the pregnancy outcomes of women who underwent conservative management of adenocarcinoma in situ (AIS).Materials and MethodsWe conducted a retrospective chart review of patients diagnosed with AIS at a single tertiary institution between January 1, 1991, and December 31, 2019. We collected demographic data, AIS-specific information, and fertility outcomes and performed bivariate analyses to compare demographic characteristics and AIS-specific information between patients with and without hysterectomy after diagnosis. Patients with conservative management who achieved pregnancy were described.ResultsAmong 87 patients with AIS, 38 (44%) underwent a hysterectomy within 6 months of diagnosis and 49 (56%) underwent conservative management. Six of 19 patients (32%) had residual AIS despite undergoing definitive management after an excisional procedure with negative margins and negative endocervical curettage (ECC). Nine of 19 patients (47%) had residual AIS after an excisional procedure with positive margins and/or a positive ECC. Patients who opted for conservative management were younger (median = 31.6 [interquartile range = 27.4–34.9] vs 38.5 y [32.3–44.8 y], p < .001) and nulligravid. Among patients with conservative management, there were 15 pregnancies and 14 live births (29%). Seven were preterm, although 2 were for medical indications.ConclusionsResidual AIS in patients with negative margins and ECC leading to definitive hysterectomy (32%) and the rate of preterm birth (36%) were higher than previous reports and nationally reported rates. However, only 1 patient had a preterm birth before 34 weeks. These findings reflect important information for counseling patients who elect for conservative management of AIS.

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Section: Resultsmentioning

confidence: 99%