scholarly journals Residual disease and risk factors in patients with high-grade cervical intraepithelial neoplasia and positive margins after initial conization

2015 ◽  
pp. 851 ◽  
Author(s):  
Yunfeng Fu ◽  
Xiaodong Cheng ◽  
Xinyu Wang ◽  
Xing Xie ◽  
Weiguo Lü ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Intraepithelial Neoplasia ◽  
Residual Disease ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Positive Margins

Significance of Margin and Extent of Dysplasia in Loop Electrosurgery Excision Procedure Biopsies Performed for High-Grade Squamous Intraepithelial Lesion in Predicting Persistent Disease

2007 ◽  
Vol 131 (4) ◽  
pp. 622-624
Author(s):  
Lisa N. Tyler ◽  
Nancy Andrews ◽  
Rudolph S. Parrish ◽  
Linda J. Hazlett ◽  
Soheila Korourian
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Positive Margins ◽  
Biopsy Specimens ◽  
The Status ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Abstract Context.—High-grade squamous intraepithelial lesions (cervical intraepithelial neoplasia 2 and 3) are commonly treated with loop electrosurgery excision procedure (LEEP) biopsies. Objective.—To highlight the significance of positive margins and extent of positive margins of the cervical LEEP biopsies in predicting the persistence of high-grade squamous intraepithelial lesion and to provide suggestions for reporting margins in cervical LEEP biopsies. Design.—The pathology files at the University of Arkansas for Medical Sciences were searched for cervical intraepithelial neoplasia 2 and 3 treated by LEEP biopsy from 1990 to 2001. Results.—A total of 489 LEEP biopsy specimens were retrieved and reviewed; 270 patients had follow-up within 1 year. The biopsy specimens of 110 patients showed positive endocervical margins. One hundred sixty specimens had negative ectocervical-endocervical margins. Follow-up of 54% of the cases with initial positive margins showed residual high-grade squamous intraepithelial lesions. This association was even greater when multiple blocks showed positive endocervical margins and in cases with positive deep margins. On the other hand, a negative margin predicted ability to completely remove the lesion in 95% of patients. Conclusion.—This study reiterates the significance of the evaluation of the margin, even in samples that were received as multiple fragments. Reporting of LEEP biopsy findings should include the extent of the dysplasia, the status of the ectocervical-endocervical margin, and the status of the deep margin.

Prediction of disease persistence after conization for microinvasive cervical carcinoma and cervical intraepithelial neoplasia grade 3

2004 ◽  
Vol 14 (2) ◽  
pp. 311-316 ◽  
Author(s):  
H. Lin ◽  
H. Y. Chang ◽  
C. C. Huang ◽  
C. C. Changchien
Keyword(s):  
Risk Factors ◽  
Cervical Intraepithelial Neoplasia ◽  
Cervical Carcinoma ◽  
Residual Disease ◽  
Characteristic Curve ◽  
Intraepithelial Neoplasia ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Microinvasive Carcinoma ◽  
Grade 3 ◽  
Disease Persistence

We attempted to determine the significant variables and to predict the probability of disease persistence after conization for microinvasive cervical carcinoma and cervical intraepithelial neoplasia grade 3 (CIN3). We analyzed 133 patients from 2001 to 2002 who had a subsequent hysterectomy after conization. The histological findings of the cone specimens, together with the clinical parameters, were correlated with the presence of residual dysplasia in the hysterectomy specimen. The probability of having residual dysplasia was calculated based on the function of the significant variables obtained by logistic regression analysis. Of the 133 patients, 42 (31.6%) had residual disease in their hysterectomy specimens. Using multivariate analysis only for the postmenopausal state, positive endocervical curettage, positive margin, and microinvasive carcinoma were predictive of residual dysplasia. The probabilities of having residual dysplasia were about 0.99, 0.84, 0.4, 0.07, and 0.01 in patients with a presence of all four, any three, any two, any one, and no risk factors, respectively. The best cutoff probability determined by the receiver operating characteristic curve was 0.32, yielding a sensitivity of 81% and a specificity of 88%. Based on these results, patients with the presence of any two or more of the risk factors mentioned above should be considered as a high-risk group for having disease persistence after conization for the treatment of CIN3 and microinvasive carcinoma.

Role of high-risk human papillomavirus (HPV) mRNA testing in the prediction of residual disease after conisation for high-grade cervical intraepithelial neoplasia

2011 ◽  
Vol 123 (2) ◽  
pp. 257-262 ◽  
Author(s):  
Ameli Tropé ◽  
Christine M. Jonassen ◽  
Katrine D. Sjøborg ◽  
Mari Nygård ◽  
Fredrik A. Dahl ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Cervical Intraepithelial Neoplasia ◽  
Residual Disease ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Hpv Mrna
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