Human papillomavirus combined with cytology and margin status identifies patients at risk for recurrence after conization for high-grade cervical intraepithelial neoplasia.
Eur J Gynaecol Oncol
; 36(3): 245-51, 2015.
Article
em En
| MEDLINE
| ID: mdl-26189247
ABSTRACT
OBJECTIVE:
To compare the ability of cytology, human papillomavirus (HPV) testing and co-testing to identify recurrence of patients treated by loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 2-3. MATERIALS ANDMETHODS:
Retrospective analysis (R.A.) the medical records of 372 women treated for CIN 2-3 were reviewed. Resection margin, HPV typing, Pap smears, and biopsies post-LEEP were collected. Prospective analysis (P.A.) 97 women were followed post-LEEP by cytology, HPV test and colposcopy every six months.RESULTS:
Positive margins were found to be an independent risk factor for recurrent disease (OR 0.192; 95% CI 0.074-0.497 in R.A. and OR 0.096; 95% CI 0.023-0.392 in P.A.). HPV testing showed less sensitivity than cytology (69% vs 84%, respectively in R.A. and 80% vs 100% in P.A.). Co-testing predicted recurrent disease at a sensitivity of 90.6% in R.A. and 100% in P.A.CONCLUSION:
Co-testing is the best option in follow-up protocols after treatment for CIN 2-3. If margins are free and co-testing is negative at six and 12 months, 18 months visit could be avoided.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
DNA Viral
/
Displasia do Colo do Útero
/
Neoplasias do Colo do Útero
/
Conização
/
Infecções por Papillomavirus
/
Recidiva Local de Neoplasia
Tipo de estudo:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Eur J Gynaecol Oncol
Ano de publicação:
2015
Tipo de documento:
Article