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Outcome of cervical intraepithelial neoplasia 2 diagnosed by punch biopsy in 131 women
Author(s) -
Ding Zongqun,
Jiang Chunping,
Shore Timothy,
Pather Selvan,
Dalrymple Christopher,
Atkinson Kenneth,
Murali Rajmohan,
Yousef AlRayyan Ehab Salem,
Luo Kehui,
Carter Jonathan
Publication year - 2011
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2010.01427.x
Subject(s) - medicine , cervical intraepithelial neoplasia , biopsy , dysplasia , colposcopy , cytology , surgery , cervical cancer , cancer , pathology
Aim: To study the outcome of biopsy‐diagnosed cervical intraepithelial neoplasia (CIN) 2 in patients treated by loop electrosurgical excision procedure (LEEP) or cold knife cone biopsy (CKC). Material and Methods: Patients ( n = 131) were analyzed for histological results on LEEP/CKC specimen. Demographic and risk factors, referral cytology, high risk human papilloma virus (HR HPV) test and follow‐up colposcopic clinic visits were studied. Results: Excisional specimens from LEEP/CKC demonstrated no CIN in 20 (15%), CIN 1 in 17 (13%), CIN 2 in 57 (44%) and CIN 3 in 37 (28%). No invasive cancers were identified. The referral Pap smear was high grade or possible high grade in 52 (40%), low grade in 59 (45%) and inconclusive in 20 (15%). Fourteen patients (11%) had positive excisional margins, eight of the 14 were tested for HR HPV infection before LEEP, and all were positive. Post‐treatment HPV testing was performed at the 12‐month visit in 6 of the 14 patients who had positive excision margins, and all 6 tested were negative. Two women (1.5%) with clear margins had recurrence of CIN 2, both tested positive for HR HPV after treatment. Conclusion: Our data showed that a significant number of women (28%) with biopsy‐diagnosed CIN 2 had CIN 1 or no dysplasia on subsequent excisional biopsy. The recurrence risk of high grade dysplasia in CIN 2 is low (1.5%). However, due to the high number of patients (72%) with high grade dysplasia at treatment biopsy, caution needs to be exercised when a conservative approach is adopted in the management of CIN 2.