title: Involved LEEP excision margins as predictor of residual/recurrent disease in HIV-positive and HIV-negative women in a low-resource setting.
abstract: OBJECTIVE
  To describe the accuracy of the diagnosis of involved excision margins after loop electrosurgical excision procedure (LEEP) in a low-resource setting.
  
  
  METHODS
  Cross-sectional study of 176 LEEPs indicated for a cytological report of high-grade squamous intraepithelial lesion (HGSIL). A total of 72 HIV-positive and 104 HIV-negative women with cervical intraepithelial neoplasia (CIN) ≥ 2 on their LEEP histology report with involved excision margins were enrolled in the study. All patients underwent either a repeat LEEP or a hysterectomy. The specimens were evaluated for residual/recurrent CIN ≥ 2 or less.
  
  
  RESULTS
  Persistent/recurrent CIN ≥ 2 was diagnosed in 139 (79.4%) instances and microinvasive squamous cell carcinoma in 6 (3.4%). Thirty (17.2%) showed CIN1. The persistence/recurrence rate was 72.2% and 88.5% in HIV-positive and HIV-negative women, respectively (χ2 = 7.5, p = 0.006).
  
  
  CONCLUSIONS
  In > 80% the diagnosis of involved excision margins was confirmed, a positive predictive value of 82.4%. In the absence of more accurate follow-up methods such as HPV testing or co-testing with cytology, a correct diagnosis of margin status, especially when involved, is an important guide to further management and follow-up.
authors.forename: Louis-Jacques
authors.initials: LJ
authors.lastname: van Bogaert
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery / Q000821:virology; D019092:Conization / Q000379:methods; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004598:Electrosurgery; D005260:Female; D015658:HIV Infections / Q000150:complications; D006295:Health Resources; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018365:Neoplasm, Residual; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000601:surgery* / Q000821:virology