title: Outcome of Persistent Low-Grade Cervical Intraepithelial Neoplasia Treated With Loop Electrosurgical Excision Procedure.
abstract: OBJECTIVE
  The aim of the study was to evaluate the outcome of persistent (≥2 years) low-grade cervical intraepithelial neoplasia (CIN 1) treated with loop electrosurgical excision procedure (LEEP).
  
  
  METHODS
  A study of 252 subjects with persistent biopsy-confirmed CIN 1 diagnosed after low-grade squamous intraepithelial lesions or atypical squamous lesions of undetermined significance on Papanicolaou test and treated with LEEP. Post-LEEP follow-up cytological, colposcopic, and molecular diagnostic examinations were scheduled at 6 months, 1 year, and yearly thereafter.
  
  
  RESULTS
  The 252 subjects enrolled had a total number of 1,008 visits per colposcopies (median = 3, range = 1-7) during a median post-LEEP follow-up of 25 months (range = 12-121). The cumulative incidence of CIN 2+ at 2 years and at 3 years of follow-up was 2.3% (4/176) and 5.5% (7/128), respectively, or 1.7 cases (95% CI = 1-2.8) per 100 woman-years. Low-grade cervical lesions during post-LEEP follow-up were diagnosed in 70 subjects (27.8%) or 10 cases (95% CI = 7.9-12.6) per 100 woman-years. Overall, persistent and multiple high-risk HPV infections during follow-up were associated with increased rates of CIN persistence or progression.
  
  
  CONCLUSIONS
  Women with persistent CIN 1 after atypical squamous lesions of undetermined significance/low-grade squamous intraepithelial lesion treated with LEEP had a low rate of progression to CIN 2+ but remained at a high risk of low-grade cervical abnormalities during follow-up. This information should be taken into account when deciding on the treatment strategy and counseling women with persistent CIN 1.
authors.affiliation: Departments of 1Obstetrics and Gynecology and 2Pathology, University of Pavia, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
authors.forename: Arsenio
authors.initials: A
authors.lastname: Spinillo
authors.forename: Barbara
authors.initials: B
authors.lastname: Gardella
authors.forename: Anna Daniela
authors.initials: AD
authors.lastname: Iacobone
authors.forename: Mattia
authors.initials: M
authors.lastname: Dominoni
authors.forename: Stefania
authors.initials: S
authors.lastname: Cesari
authors.forename: Paola
authors.initials: P
authors.lastname: Alberizzi
mesh_terms: D000328:Adult; D003127:Colposcopy; D003584:Cytological Techniques; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D016896:Treatment Outcome; D002578:Uterine Cervical Dysplasia / Q000601:surgery*