INTRODUCTION: Loop electrosurgical excision procedure (LEEP) is a basic procedure in the conization performed on patients with CIN II/III. After excisional therapy, close follow up is essential for the earlier detection of residual and recurrent disease. The value of PAP-smear and HPV-DNA tests for investigation of residual and recurrent disease in patients diagnosed with high-grade intraepithelial lesion after LEEP treatment was purposed. MATERIALS AND METHODS: 42 patients were included in the study for whom epithelial cell anomalies were detected at PAP-smear screening. HPV-DNA test, colposcopy, cervical biopsy and endocervical curettage and then LEEP procedures were performed. The patients were followed with HPV DNA and PAP-smear tests in terms of recurrence and residual disease at 3-month intervals. RESULTS: HPV-DNA examination revealed that 36 patients (85.7%) were positive for high-risk HPV-DNA before treatment. Histopathological evaluation of LEEP materials revealed the presence of CIN I in 4 and CIN II/III in 38 patients. Surgical margin was positive in five patients. No sign of invasive cervical neoplasia was detected. The high-risk HPV DNA's persistence was observed in 11 (30.6%) of the 36 patients of whom HPV-DNA positivity had been detected before the treatment. HSIL was detected in four patients using PAP-smear on the third month examination. Positive LEEP surgical margins were found to be positively correlated both with HPV-DNA positivity detected during the follow-up examination and with the presence of residual disease in the follow-up PAP smear. CONCLUSION: LEEP is a basic procedure in the conization performed on patients with CIN II/III. In spite of high recurrence and residual disease rates, this kind of patients requires close monitoring. Follow-up with HPV and PAP-smear tests after LEEP treatment is of great importance in the detection of residual or recurrent disease.
INTRODUCTION: Loop electrosurgical excision procedure (LEEP) is a basic procedure in the conization performed on patients with CIN II/III. After excisional therapy, close follow up is essential for the earlier detection of residual and recurrent disease. The value of PAP-smear and HPV-DNA tests for investigation of residual and recurrent disease in patients diagnosed with high-grade intraepithelial lesion after LEEP treatment was purposed. MATERIALS AND METHODS: 42 patients were included in the study for whom epithelial cell anomalies were detected at PAP-smear screening. HPV-DNA test, colposcopy, cervical biopsy and endocervical curettage and then LEEP procedures were performed. The patients were followed with HPV DNA and PAP-smear tests in terms of recurrence and residual disease at 3-month intervals. RESULTS: HPV-DNA examination revealed that 36 patients (85.7%) were positive for high-risk HPV-DNA before treatment. Histopathological evaluation of LEEP materials revealed the presence of CIN I in 4 and CIN II/III in 38 patients. Surgical margin was positive in five patients. No sign of invasive cervical neoplasia was detected. The high-risk HPV DNA's persistence was observed in 11 (30.6%) of the 36 patients of whom HPV-DNA positivity had been detected before the treatment. HSIL was detected in four patients using PAP-smear on the third month examination. Positive LEEP surgical margins were found to be positively correlated both with HPV-DNA positivity detected during the follow-up examination and with the presence of residual disease in the follow-up PAP smear. CONCLUSION: LEEP is a basic procedure in the conization performed on patients with CIN II/III. In spite of high recurrence and residual disease rates, this kind of patients requires close monitoring. Follow-up with HPV and PAP-smear tests after LEEP treatment is of great importance in the detection of residual or recurrent disease.
Authors: Anne F Rositch; Heidi M Soeters; Tabatha N Offutt-Powell; Bradford S Wheeler; Sylvia M Taylor; Jennifer S Smith Journal: Gynecol Oncol Date: 2014-01-07 Impact factor: 5.482
Authors: Ricardo Rosales; Mario López-Contreras; Carlos Rosales; Jose-Roberto Magallanes-Molina; Roberto Gonzalez-Vergara; Jose Martin Arroyo-Cazarez; Antonio Ricardez-Arenas; Armando Del Follo-Valencia; Santiago Padilla-Arriaga; Miriam Veronica Guerrero; Miguel Angel Pirez; Claudia Arellano-Fiore; Freddy Villarreal Journal: Hum Gene Ther Date: 2014-12 Impact factor: 5.695
Authors: Sarah R Hoffman; Tam Le; Alexandre Lockhart; Ayodeji Sanusi; Leila Dal Santo; Meagan Davis; Dana A McKinney; Meagan Brown; Charles Poole; Corinne Willame; Jennifer S Smith Journal: Int J Cancer Date: 2017-02-27 Impact factor: 7.396