Pathological discrepancy between colposcopic directed cervical biopsy and Loop Electrosurgical-Excision Procedures (LEEPs) in patients with biopsies proven high grade cervical intraepithelial neoplasia

Noothong, Sitchuphong; Inthasorn, Perapong; Warnnissorn, Malee

doi:10.1016/j.tjog.2017.08.009

Cited by 13 publications

(12 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, there was no association between CIN 2 in colposcopic directed biopsy specimens and CIN 1 or less in LEEP specimens. This finding was different from that of most previous studies which have shown CIN 2 in colposcopic directed biopsy specimens was the predicting factor of having CIN 1 or less in LEEP specimens (Giannella et al, 2015;Nam et al, 2015;Zhang et al, 2015;Noothong et al, 2017). Our study found that low grade colposcopic impression was a predicting factor of having CIN 1 or less in LEEP specimens.…”

Section: Discussioncontrasting

confidence: 99%

“…This study showed 25.4% of CIN 1 or less in LEEP specimens of patients with colposcopic directed biopsy-confirmed CIN 2-3. Previous studies have reported the prevalence of 14-24% of pathological discrepancy (Ryu et al, 2010;Witt et al, 2012;Rodriguez-Manfredi et al, 2013;Giannella et al, 2015;Nam et al, 2015;Zhang et al, 2015;Noothong et al, 2017). The rates of pathological discrepancy varied because of differences in studied population and definition of pathological discrepancy among studies.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predictors of Absent High-grade Cervical Intraepithelial Neoplasia (CIN) in Loop Electrosurgical Excision Procedure Specimens of Patients with Colposcopic Directed Biopsy-Confirmed High-Grade CIN

Poomtavorn

Tanprasertkul

Sammor

et al. 2019

Asian Pac J Cancer Prev

View full text Add to dashboard Cite

Objective:To determine predictors of having cervical intraepithelial neoplasia (CIN) 1 or less in loop electrosurgical excision procedure (LEEP) specimens of patients with colposcopic directed biopsy-confirmed CIN 2-3. Methods: Two hundred and eighty patients with colposcopic directed biopsy-confirmed CIN 2-3 who subsequently underwent LEEP were enrolled in the retrospective study. Related clinical data were collected to determine the predictors of CIN 1 or less in LEEP specimens. Results: CIN 1 or less in LEEP specimens was found in 71 (25.4%) of 280 patients. Multivariate logistic regression analyses demonstrated that nulliparity [OR (95% CI) = 3.375 (1.245-9.150)], low grade Papanicolaou (Pap) results [OR (95% CI) = 6.410 (2.877-14.280)] and low grade colposcopic impression [OR (95% CI) = 16.506 (5.844-46.632)] were significant risk factors of having CIN 1 or less in LEEP specimens. Neither persistent nor recurrent CIN 2-3 was detected in 71 patients who had CIN 1 or less in LEEP specimens. However, persistent or recurrent CIN 2-3 developed in 3 out of 209 (1.4%) patients with CIN 2-3 found in LEEP specimens. Conclusion: Approximately 25% of patients with CIN 2-3 in colposcopic directed biopsy specimens had CIN 1 or less found in LEEP specimens. Predicting factors of having CIN 1 or less in LEEP specimens were nulliparity, low grade Pap results and low grade colposcopic impression.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of Absent High-grade Cervical Intraepithelial Neoplasia (CIN) in Loop Electrosurgical Excision Procedure Specimens of Patients with Colposcopic Directed Biopsy-Confirmed High-Grade CIN

Poomtavorn

Tanprasertkul

Sammor

et al. 2019

Asian Pac J Cancer Prev

View full text Add to dashboard Cite

show abstract

“…We found that an indication of CIN 2 on pre-conization biopsy and an absence of glandular involvement were also independent relative factors. Previous studies found that CIN 2 in colposcopically directed biopsy specimens was a predicting factor for having CIN 1 or less in LEEP specimens ( 11 , 23 , 24 ). However, glandular involvement has not been found to be associated with negative conization in previous studies.…”

Section: Discussionmentioning

confidence: 94%

Absence of high-grade cervical intraepithelial neoplasia in conization specimens from patients with colposcopic biopsy-confirmed high-grade cervical intraepithelial neoplasia: Retrospective study of 1695 cases

et al. 2022

View full text Add to dashboard Cite

Few studies have investigated the absence of high-grade cervical intraepithelial neoplasia (CIN) in excised specimens, and sample sizes of these studies were limited. This study retrospectively analyzed clinical characteristics of 1695 patients with CIN 2/3 to determine the incidence rate and relative factors of CIN 1 or less in conization specimens from patients with colposcopic biopsy-confirmed CIN 2/3. The study group comprised 430 cases of CIN 1 or less in conization specimens, and the control group comprised 1142 cases with high-grade CIN lesions in conization specimens. Univariate and multivariate logistic regression models were established to evaluate relative factors. The 1–9 years follow-up data were analyzed to determine the persistence/recurrence rate. Multivariate logistic regression showed that patients aged 18–24 years (OR (95% CI) = 2.224 (1.014, 4.877)); with a negative hrHPV test result (OR (95% CI) = 3.210 (1.627, 6.331)); a cytology test result of normal (OR (95% CI) = 5.184 (3.138, 8.563)), ASC-US (OR (95% CI) = 3.420 (2.102, 5.564)), LSIL (OR (95% CI) = 2.588 (1.475, 4.541)), or ASC-H (OR (95% CI) = 2.434 (1.306, 4.539)); an indication of CIN 2 on biopsy (OR (95% CI) = 2.290 (1.694, 3.096)), and no glandular involvement (OR (95% CI) = 1.616 (1.205, 2.169)) were more likely to have an absence of high-grade dysplasia in conization specimens. There was no difference in the persistence/recurrence rate between the two groups (x2 = 1.55, P = 0.46). An age of 18–24 years, a negative hrHPV test result, a non-HSIL cytology test result, an indication of CIN 2 on biopsy, and no glandular involvement were relative factors for an absence of high-grade dysplasia in conization specimens. For patients with relative factors, especially young women, informed follow-up should be considered.

show abstract

“…Long recognizes that, according to Massad, 5.9% of HIVpositive women develop a high-grade lesion among 1,639 study candidates, even though progression rates are reported to be lower among young women. [10] A study in Kenya demonstrated the highest prevalence of RA-HPV serotypes among women living with HIV, reporting that 61% of a series with high-grade lesions had serotypes 16 and / or 18. [11]…”

Section: Factors Related To the Patientmentioning

confidence: 99%

Contextualization of the Study of Residual Lesions in Conized Patients

Gómez¹,

Sierra²,

Rodríguez³

2021

ASS

View full text Add to dashboard Cite

In the last years, it is evidenced of more remarkable way, an increment of the incidence of the cervical cancer and their lesions precursors in young patients. Conization, as an excisional method, is recommended in the treatment of high-grade epithelial lesions, as well as in the microinvasive stage of cervical cancer when satisfied parity has not yet been achieved. In Clinical Medicine, finding a balance between therapeutic effectiveness and iatrogenic intervention by exaggerated treatments is a challenge, a current scenario in which the probability of the appearance of residual lesions after conization is framed. Although factors related with the biggest probability of appearance of residual lesions are described in patient conizadas, models that demonstrate the interrelation between these variables don't exist; most of the studies are limited to the individual analysis of these factors. The current scientific evidences allow to state that the appearance of post-cone residual lesions is a multifactorial phenomenon dependent on elements related to the nature of the lesion, the surgical technique and the competence of the surgeon; even several of these predictive elements are interrelated in the same patient. The knowledge of these predictors factors of residual lesion, starting from the pattern of the three dimensions, allows to trace clinical and formative strategies of intervention.

show abstract

Pathological discrepancy between colposcopic directed cervical biopsy and Loop Electrosurgical-Excision Procedures (LEEPs) in patients with biopsies proven high grade cervical intraepithelial neoplasia

Abstract: The prevalence of patients with CIN1 or less from LEEP specimens who previously had colposcopic biopsies proven CIN2 or 3 was 16.3%. CIN2 from biopsy was the statistically significant risk factor of CIN1 or less in LEEP specimens.

Cited by 13 publications

References 12 publications

Predictors of Absent High-grade Cervical Intraepithelial Neoplasia (CIN) in Loop Electrosurgical Excision Procedure Specimens of Patients with Colposcopic Directed Biopsy-Confirmed High-Grade CIN

Predictors of Absent High-grade Cervical Intraepithelial Neoplasia (CIN) in Loop Electrosurgical Excision Procedure Specimens of Patients with Colposcopic Directed Biopsy-Confirmed High-Grade CIN

Absence of high-grade cervical intraepithelial neoplasia in conization specimens from patients with colposcopic biopsy-confirmed high-grade cervical intraepithelial neoplasia: Retrospective study of 1695 cases

Contextualization of the Study of Residual Lesions in Conized Patients

Contact Info

Product

Resources

About