title: Cervical intraepithelial neoplasia grade 3 lesions can regress.
abstract: Up to 30% of cervical intraepithelial grades 2-3 (CIN2-3) lesions regress, but some believe that "regression" is due to "curative" punch biopsies. If this is true, CIN2-3 in the resection margins of the biopsies would be associated with more frequent "persistent" CIN2-3. If, however, immunology-related regression exists, regression would increase with increasing biopsy-cone interval. In 61 punch biopsies diagnosed as CIN3 at careful review by two independent gynaecological pathologists, CIN3 in the resection margins and duration of the biopsy-cone interval was evaluated in relation to CIN2-3-or-not in the cones (again after independent review by expert pathologists). 10 of 61 (16%) patients with CIN3 showed CIN1 or less in the follow-up cones. CIN3-or-not in the resection margins, size of the lesion in the punch biopsy, and presence or absence of CIN2-3 in the cones were not correlated with regression-or-not. However, the number of cones without CIN2-3 increased with longer biopsy-cone interval, 5% in patients with a punch-cone biopsy interval under 9 weeks and 38%> or =9 weeks (p<0.001). These results favour the hypothesis that CIN3 can regress, and do not support the "curative punch biopsy" theory.
authors.affiliation: Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Ane Cecilie
authors.initials: AC
authors.lastname: Munk
authors.forename: Arnold-Jan
authors.initials: AJ
authors.lastname: Kruse
authors.forename: Bianca
authors.initials: B
authors.lastname: van Diermen
authors.forename: Emiel A M
authors.initials: EA
authors.lastname: Janssen
authors.forename: Ivar
authors.initials: I
authors.lastname: Skaland
authors.forename: Einar
authors.initials: E
authors.lastname: Gudlaugsson
authors.forename: Stein Tore
authors.initials: ST
authors.lastname: Nilsen
authors.forename: Jan P A
authors.initials: JP
authors.lastname: Baak
mesh_terms: D001706:Biopsy / Q000379:methods; D005260:Female; D006801:Humans; D009365:Neoplasm Regression, Spontaneous; D013995:Time; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery