OBJECTIVE: The purpose of this study was to review outcomes from LLETZ (large loop excision of the transformation zone) procedures carried out for high-grade cervical intraepithelial neoplasia (CIN), in particular findings at colposcopy, cytology and HR-HPV(high-risk human papilloma virus) result to assess whether colposcopy provides any additional information in the management of women at 12 months. METHODS: We retrospectively analysed 252 patients who had a LLETZ procedure for a HSIL (high-grade squamous intraepithelial lesion) between January 2005 and December 2010. RESULTS: Eighty per cent of women who had a LLETZ procedure for HSIL were reviewed in our colposcopy clinic at 12 months after the procedure. Colposcopy at 12 months after LLETZ was documented as unsatisfactory for 30% of these women. The sensitivity of colposcopy at 12 months after LLETZ was 0.47, and the specificity was 0.95. CONCLUSION: Colposcopy examination is an insensitive tool for detection of persisting HPV-related change after excision of high-grade CIN. Its usefulness to investigate persistent or recurrent HSIL is further reduced by the high rate of unsatisfactory colposcopy examinations after a LLETZ procedure. Papanicolaou smear and HRHPV tests may be adequate follow-up at 12 months after LLETZ for women at low risk of recurrence of HSIL.
OBJECTIVE: The purpose of this study was to review outcomes from LLETZ (large loop excision of the transformation zone) procedures carried out for high-grade cervical intraepithelial neoplasia (CIN), in particular findings at colposcopy, cytology and HR-HPV(high-risk human papilloma virus) result to assess whether colposcopy provides any additional information in the management of women at 12 months. METHODS: We retrospectively analysed 252 patients who had a LLETZ procedure for a HSIL (high-grade squamous intraepithelial lesion) between January 2005 and December 2010. RESULTS: Eighty per cent of women who had a LLETZ procedure for HSIL were reviewed in our colposcopy clinic at 12 months after the procedure. Colposcopy at 12 months after LLETZ was documented as unsatisfactory for 30% of these women. The sensitivity of colposcopy at 12 months after LLETZ was 0.47, and the specificity was 0.95. CONCLUSION: Colposcopy examination is an insensitive tool for detection of persisting HPV-related change after excision of high-grade CIN. Its usefulness to investigate persistent or recurrent HSIL is further reduced by the high rate of unsatisfactory colposcopy examinations after a LLETZ procedure. Papanicolaou smear and HRHPV tests may be adequate follow-up at 12 months after LLETZ for women at low risk of recurrence of HSIL.
Authors: Annarosa Del Mistro; Mario Matteucci; Egle Alba Insacco; GianLibero Onnis; Filippo Da Re; Lorena Baboci; Manuel Zorzi; Daria Minucci Journal: Biomed Res Int Date: 2015-06-09 Impact factor: 3.411