Clinical significance of a negative loop electrosurgical excision procedure, conization and hysterectomy for cervical intraepithelial neoplasia.
OBJECTIVE
The absence of cervical intraepithelial neoplasia (CIN) in a loop electrosurgical excision procedure (LEEP), cold-knife conization and hysterectomy for treatment of CIN is an occasional finding of uncertain clinical significance. The aim of this study was to estimate the frequency of a negative procedure and its relationship to disease recurrence.


METHODS
A retrospective study was conducted on 263 specimens from women submitted to the LEEP (n = 142), conization (n = 101) or hysterectomy (n = 20) due to CIN.


RESULTS
The frequency of negative conization, LEEP and hysterectomy were, respectively, 15.5%, 19.8% and 25%. Recurrence occurred from 16 to 44 (median = 42) months in women with negative surgical specimens (LEEP or cold knife conization), and after five to 31 (median = 20) months after histological findings of CIN in surgical specimens, respectively, 7.1% and 11.2%.


CONCLUSIONS
The absence of CIN in those procedures of biopsy-confirmed CIN is a not an uncommon finding. Patients with positive or negative specimens should be carefully followed.
Murta
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EF
Discipline of Gynecology and Obstetrics, Federal University of Triângulo Mineiro, Uberaba, MG, Brazil.
Silva
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AO
Silva
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EA
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D003127:Colposcopy / Q000379:methods; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007150:Immunohistochemistry; D015994:Incidence; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery*