[What kind of follow-up after surgical treatment for high-grade cervix lesion?].
The women treated for a high-grade cervical lesion (CIN2+) have a high and prolonged (beyond 25 years) risk of recurrence (x 5 compared to the general population) of cervical as well as extracervical lesion. The cytological and colposcopic protocols of follow-up raise the problem of their insufficient sensitivity, and the compliance of the patients to this prolonged follow-up is low. Test HPV seeking the presence of high-risk HPV benefits from a high sensitivity and presents altogether a very strong negative predictive value. The addition of this test to the cytological monitoring three to six months after the conization makes it possible to distinguish a group of patients with low risk (with both tests negative) being able to profit from a traditional follow-up, from a high-risk group having at least one positive test, whose surveillance must be reinforced (with triage by colposcopy), prolonged in time and extended beyond the cervix. Like as the primary screening of cervical lesions, the follow-up of the patients after conization must profit from the addition of test HPV and would deserve protocolization and organization.
Mergui
J-L
JL
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, Assistance publique-Hôpitaux de Paris (AP-HP), 4, rue de la Chine, 75020 Paris, France.
Levêque
J
J
D003127:Colposcopy / Q000592:standards; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000601:surgery*; D010349:Patient Compliance; D011182:Postoperative Care / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000601:surgery* / Q000821:virology; D014626:Vaginal Smears / Q000592:standards; D002578:Uterine Cervical Dysplasia / Q000601:surgery* / Q000821:virology
D004279:DNA, Viral