Cervical intraepithelial neoplasia grade 3 lesions can regress.
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.
Munk
Ane Cecilie
AC
Department of Pathology, Stavanger University Hospital, Stavanger, Norway.
Kruse
Arnold-Jan
AJ
van Diermen
Bianca
B
Janssen
Emiel A M
EA
Skaland
Ivar
I
Gudlaugsson
Einar
E
Nilsen
Stein Tore
ST
Baak
Jan P A
JP
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