Chengquan Zhao1, Wei Hong2, Zaibo Li3, Baoying Weng2, Millon Amin3, R Marshall Austin3. 1. Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Electronic address: zhaoc@upmc.edu. 2. Department of Pathology, Conemaugh Health System, Johnstown, Pennsylvania. 3. Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Abstract
INTRODUCTION: Recently published guidelines now specifically recommend cytology and HPV cotesting as follow-up after high-grade cervical intraepithelial neoplasia (CIN 2/3) excision. MATERIALS AND METHODS: A total of 988 patients with CIN 2/3 treated by excision between July 2005 and December 2009 were identified with available "test of cure" follow-up results over an average of 36 months. Average age was 32 years. RESULTS: CIN 2/3 was reported during follow-up in 67 of 988 (6.8%) patients; 45 of 67 (67.2%) follow-up CIN 2/3 diagnoses were within 2 years of excision. Post-treatment CIN 2/3 was significantly more likely after initial CIN 3 grade, positive excision margins, and human papillomavirus (HPV)-positive follow-up results, but not significantly associated in this cohort with age. A total of 514 women had follow-up HPV tests, and 32.3% had at least 1 HPV-positive result. Post-treatment CIN 2/3 was diagnosed in 24 of 165 (14.5%) patients with at least 1 follow-up HPV-positive result and in 6 of 349 (1.7%) with only follow-up HPV-negative results. No HPV-negative/cytology-negative follow-up results were documented among 30 post-treatment patients later developing recurrent CIN 2/3. CONCLUSIONS: Cytology and HPV cotesting facilitates early intervention during follow-up after CIN 2/3 excision.
INTRODUCTION: Recently published guidelines now specifically recommend cytology and HPV cotesting as follow-up after high-grade cervical intraepithelial neoplasia (CIN 2/3) excision. MATERIALS AND METHODS: A total of 988 patients with CIN 2/3 treated by excision between July 2005 and December 2009 were identified with available "test of cure" follow-up results over an average of 36 months. Average age was 32 years. RESULTS:CIN 2/3 was reported during follow-up in 67 of 988 (6.8%) patients; 45 of 67 (67.2%) follow-up CIN 2/3 diagnoses were within 2 years of excision. Post-treatment CIN 2/3 was significantly more likely after initial CIN 3 grade, positive excision margins, and human papillomavirus (HPV)-positive follow-up results, but not significantly associated in this cohort with age. A total of 514 women had follow-up HPV tests, and 32.3% had at least 1 HPV-positive result. Post-treatment CIN 2/3 was diagnosed in 24 of 165 (14.5%) patients with at least 1 follow-up HPV-positive result and in 6 of 349 (1.7%) with only follow-up HPV-negative results. No HPV-negative/cytology-negative follow-up results were documented among 30 post-treatment patients later developing recurrent CIN 2/3. CONCLUSIONS: Cytology and HPV cotesting facilitates early intervention during follow-up after CIN 2/3 excision.
Authors: Megan A Clarke; Elizabeth R Unger; Rosemary Zuna; Erin Nelson; Teresa M Darragh; Miriam Cremer; Colleen K Stockdale; Mark H Einstein; Nicolas Wentzensen Journal: J Low Genit Tract Dis Date: 2020-04 Impact factor: 3.842