Prediction of Persistence or Recurrence After Conization for Cervical Intraepithelial Neoplasia III

Lu, Chien-Hsing; Liu, Fu-Shing; Kuo, Cheng‐Deng; Chang, Chia‐Che; Ho, Esther Shih-Chu

doi:10.1097/01.aog.0000206777.28541.fc

Cited by 57 publications

(48 citation statements)

References 15 publications

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“…The specificity of ECC is high in both groups, younger women 0.83 and older patients 0.94, whereas the positive endocervical margin showed low specificity in both groups, 0.64 and 0.56. These findings concerning the sensitivity and specificity of ECC and endocervical margin status are similar to that reported by Lu et al (8). The sensitivity of ECC was 0.581 versus 0.655 for the endocervical margin, while the specificity of ECC was 0.943 versus 0.836 for the endocervical margin.…”

Section: Discussionsupporting

confidence: 90%

“…Lu et al (9) found incidences for residual disease in 56.5% of patients over 50 years and in 29.3% of patients younger than fifty years. An explanation for the results could be the fact that the transformation zone in older women is retracted into the endocervical canal (deep inversion) and that a progressive atrophy of the genital tract occurs in elder women (4,(7)(8)(9)(10). The sensitivity of ECC for residual CIN and/or carcinoma is low in both age groups,, 0.35 and 0.44, respectively, whereas sensitivity of a positive endocervical margin status of the cone is higher in both groups, 0.79 and 0.69, respectively.…”

Section: Discussionmentioning

confidence: 99%

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The value of endocervical curettage after conization for cervical intraepithelial neoplasia

Schneider¹,

Orelli

Roos³

et al. 2012

Annals of Diagnostic Pathology

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The objective of this study is to assess the value of postcone endocervical curettage, after conization of cervical intraepithelial neoplasia or carcinoma as a predictive tool for residual lesions. This is a retrospective observational study. All data were obtained by the University Hospital of Zurich, Department of Gynaecology. One hundred fifty patients underwent hysterectomy within 12 months after conization and endocervical curettage from 1993 to 2006. To analyze the sensitivity, specificity, and the positive predictive value (PPV) and negative predictive value (NPV) of the endocervical curettage after conization, we used the Fisher exact test and (2) Methods: To analyse the sensitivity, specificity, the positive and negative predictive values of the endocervical curettage following conization we used the Fisher's exact test and Chi2-Test. The value of endocervical curettage (ECC) following conization for cervical intraepithelial neoplasia (CIN) Main outcome measures:The sensitivity and specificity as well as the positive and negative predictive values of the post-conization endocervical curettage. Results Conclusion:The endocervical curettage following conization of cervical intraepithelial neoplasia does not generally improve the prediction of residual lesions. However, in women ≥50 years, a higher specificity and positive predictive value, 0.94 and 0.88, respectively, was observed. Therefore, this subgroup of patients may benefit from an endocervical curettage.Keywords: ECC (= endocervical curettage), sensitivity, specificity, PPV (= positive predictive value), NPV (= negative predictive value)Introduction:

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

The value of endocervical curettage after conization for cervical intraepithelial neoplasia

Schneider¹,

Orelli

Roos³

et al. 2012

Annals of Diagnostic Pathology

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“…[3] Therefore, information concerning gland involvement should influence patient management; the option of deeper conization may have advantages over LEEP or cryotherapy to ensure negative margins for suitable patients. [1–8]…”

Section: Discussionmentioning

confidence: 99%

“…[3] The information concerning EGI on Pap smears may influence the decision to perform deeper conization, LEEP biopsy or cryotherapy to ensure negative margins. [1–8]…”

Section: Introductionmentioning

confidence: 99%

Cytohistological correlation of endocervical gland involvement with high-grade squamous intraepithelial lesions

Kır

Karabulut

Yılmaz

et al. 2012

J Cytol

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Background:Diagnosis of endocervical glandular involvement by high-grade squamous intraepithelial lesion (HSIL-EGI) on Papanicolaou (Pap) smears can affect the clinical management of patients.Aim:The cytological criteria for the diagnosis of HSIL-EGI are described and the accuracy of this diagnosis was investigated.Materials and Methods:Seventeen patients diagnosed with HSIL-EGI and 40 patients with diagnosis of HSIL on Pap smears with follow-up cone or loop electrocautery excision procedure (LEEP) biopsies were included in the study. The following criteria were evaluated for the cytological diagnosis of HSIL-EGI: atypical cells with definite features of HSIL, three-dimensional atypical squamous cell clusters (TDCs) with attached benign endocervical epithelium, finger-like TDCs covered with intact epithelium on most sides, which represent the finger-like invaginations of the endocervical glandular area involved by HSIL, and the absence of cytological findings of in situ adenocarcinoma of the cervix.Results:On subsequent histopathological evaluation, 16 of 17 (94.1%) patients with a cytological diagnosis of HSIL-EGI and 17 of 40 (42.5%) patients with HSIL exhibited endocervical glandular involvement (P < 0.001, sensitivity: 48.5%, specificity: 95.8%, positive predictive value: 94.1%, negative predictive value: 57.5% and accuracy: 68.4%).Conclusion:Diagnosis of HSIL-EGI may be possible on Pap smears with a high positive predictive value and specificity but low sensitivity, possibly due to cytological sampling limitations. To clarify the results of the present study, more extensive studies with a particular emphasis on the sampling of the endocervical glandular area for cytological evaluation of the cervix are needed.

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“…A positive margin or positive postprocedure endocervical sampling is a marker for increased risk of recurrence; however, only age, lesion size, and CIN grade are independent risk factors (152,153). Even with a positive endocervical margin, 70-80% will be cured.…”

Section: How Should Ais Detected On Biopsy Be Managed? How Should Patmentioning

confidence: 99%

Practice Bulletin No. 140

2013

Obstetrics & Gynecology

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Prediction of Persistence or Recurrence After Conization for Cervical Intraepithelial Neoplasia III

Abstract: II-3.

Cited by 57 publications

References 15 publications

The value of endocervical curettage after conization for cervical intraepithelial neoplasia

The value of endocervical curettage after conization for cervical intraepithelial neoplasia

Cytohistological correlation of endocervical gland involvement with high-grade squamous intraepithelial lesions

Practice Bulletin No. 140

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