Clinical Significance of a Negative Loop Electrosurgical Excision Procedure Biopsy in Patients With Biopsy-Confirmed High-Grade Cervical Intraepithelial Neoplasia
- Authors
- Nam, Kyehyun; Ryu, Aeli; Jeon, Seob; Kim, Jeongsig; Kwak, Jeongja; Park, Bora
- Issue Date
- Apr-2015
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Keywords
- cervical intraepithelial neoplasia; follow-up studies; papillomavirus infections; recurrence
- Citation
- Journal of Lower Genital Tract Disease, v.19, no.2, pp 103 - 109
- Pages
- 7
- Journal Title
- Journal of Lower Genital Tract Disease
- Volume
- 19
- Number
- 2
- Start Page
- 103
- End Page
- 109
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/10763
- ISSN
- 1089-2591
1526-0976
- Abstract
- Objective: We sought to determine which clinical factors can predict this phenomenon and to better understand the clinical significance of negative loop electrosurgical excision procedure (LEEP) findings through long-term follow-up. Methods: We identified 559 patients with biopsy-confirmed cervical intraepithelial neoplasia grade 2 or 3 (CIN 2, 3) who were treated by LEEP between February 2001 and December 2010. Preconization clinical characteristics, as well as high-risk human papillomavirus (hrHPV) status, were analyzed as possible predictors of an absence of a lesion in the specimen. The clinical significance of an absence of a lesion in the specimen, as well as other factors, was evaluated by Cox hazard regression analysis in terms of recurrence. Results: No lesion on the LEEP specimen was found in 102 (18.2%) of 559 patients with CIN 2,3 on punch biopsy. Punch biopsy status of CIN 2, low HPV viral load (<100 relative light units [RLU]), and negative or positive HPV infection other than type 16 were significantly related to no lesion in the LEEP specimen. Postoperative HPV persistence (>= 10 RLU) and same-type HPV detection were significantly related to recurrent disease of CIN 2+ (p < .001). The recurrence of patients with no lesion in LEEP did not statistically differ from that of patients with a lesion in the LEEP specimen (p = .390). Conclusions: The absence of a lesion in the LEEP specimen is very common. A negative LEEP is associated with a persistence/recurrence rate similar to that of positive LEEP. We recommend that the follow-up for patients with no lesion in the LEEP specimen should be the same as that for patients with a lesion.
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Collections - College of Medicine > Department of Pathology > 1. Journal Articles
- College of Medicine > Department of obstetrics and Gynecology > 1. Journal Articles
- College of Medicine > Department of Obstetrics and Gynecology > 1. Journal Articles
- College of Medicine > Department of Obstetrics and Gynecology > 1. Journal Articles
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