| Title | Persistent intraepithelial neoplasia after excision for cervical intraepithelial neoplasia grade III. | | Author(s) | Gardeil F, Barry-Walsh C, Prendiville W, Clinch J, Turner MJ | | Institution | Coombe Women's Hospital, Dublin, Ireland. | | Source | Obstet Gynecol 1997 Mar; 89(3):419-22. | | MeSH | Adult
Cervical Intraepithelial Neoplasia
Female
Follow-Up Studies
Humans
Incidence
Neoplasm Recurrence, Local
Uterine Cervical Neoplasms
| | Abstract | OBJECTIVE: To determine the factors associated with subsequent intraepithelial neoplasia among patients who had cervical intraepithelial neoplasia grade III (CIN III) diagnosed on a specimen from previous large-loop excision of the transformation zone.
METHODS: We studied all large-loop excisions of the transformation zone performed between May 1991 and December 1993, inclusive. All cases of CIN III were identified. We followed up patients with cytology and colposcopy for 2 years after treatment for high-grade CIN. Findings at follow-up were analyzed.
RESULTS: A histologic diagnosis of CIN III was made in 225 patients. The lesion appeared incompletely excised in 105 patients (48.2%). In 76 cases (34.9%), CIN III was found at the endocervical margin. Of the 211 patients reviewed at 6 months, 18 (8.5%) had histologically proven CIN. The incidence of CIN was 16.5% after a report of incomplete excision, compared with 1.9% after a report of complete excision (P < .001). Furthermore, there was no subsequent CIN III in the complete-excision group. Of the 183 patients reviewed at 24 months, seven (3.8%) had histologically proven CIN. All cases of subsequent CIN were associated with dyskaryosis on follow-up cervical cytology.
CONCLUSIONS: Positive margins increase the risk of treatment failure. Cytology alone may be adequate for follow-up when CIN III is completely excised. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 9052597 |
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