title: Management of borderline change in endocervical cells: a more dependable approach.
abstract: BACKGROUND
  There are limited data and guidance from the UK on borderline nuclear change in endocervical cells (BNCs). The objective of this study is to determine the clinical outcome of women with BNCs, to determine the accuracy of colposcopy and propose a more robust management algorithm.
  
  
  METHODS
  This is a retrospective review of all BNC referrals between January 2006 and December 2011 at the Northumbria Healthcare Trust. Histological diagnosis was based on high-grade histology (CIN 2 or worse). Any high-grade histology in the first year of follow-up was included in the final diagnosis.
  
  
  RESULTS
  Of the 9001 new referrals, 167 women had BNCs. Thirty-seven (22%) were diagnosed with high-grade histology on initial assessment. Sixty women had satisfactory and negative colposcopy, out of which 7 (12%) were detected with high-grade histology/cytology in the first year of follow-up. Overall, 50 high-grade histology (30%), including two invasive carcinomas were detected.
  
  
  CONCLUSIONS
  Current follow-up of BNCs relies heavily on colposcopic assessment. A significant proportion of women with negative colposcopy was found to have high-grade histology in the first year of follow-up. We propose a more robust management algorithm to lower the probability of missed high-grade histology in this subgroup of women.
authors: Department of Obstetrics and Gynaecology, Wansbeck Hospital, Woodhorn Lane, Ashington, Northumberland NE63 9JJ, UK.
authors: S
authors: S
authors: Kodiathodi
authors: Department of Gynaecological Oncology, St James's University Hospital, Beckett Street, Leeds, West Yorkshire LS9 7TF, UK.
authors: S
authors: S
authors: Chattopadhyay
authors: Department of Obstetrics and Gynaecology, Wansbeck Hospital, Woodhorn Lane, Ashington, Northumberland NE63 9JJ, UK.
authors: A
authors: A
authors: Baldwin
authors: Department of Obstetrics and Gynaecology, Wansbeck Hospital, Woodhorn Lane, Ashington, Northumberland NE63 9JJ, UK.
authors: P
authors: P
authors: Franks
mesh_terms: D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000473:pathology; D003127:Colposcopy / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D014626:Vaginal Smears / Q000379:methods; D055815:Young Adult