Clinical Significance of a Negative Loop Electrosurgical Excision Procedure Biopsy in Patients With Biopsy-Confirmed High-Grade Cervical Intraepithelial Neoplasia. Issue 2 (April 2015)

• Record Type: Journal Article
• Authors: Nam, Kyehyun; Ryu, Aeli; Jeon, Seob; Kim, Jeongsig; Kwak, Jeongja; Park, Bora
• Is Part Of: Journal of lower genital tract disease. Volume 19:Issue 2(2015:Apr.)
• Publication Date: 2015-04
• Subjects: Generative organs, Female -- Diseases -- Periodicals; Cervix uteri -- Diseases -- Periodicals; Generative organs -- Diseases -- Periodicals; Sexually transmitted diseases -- Periodicals; 618.1
• DOI: 10.1097/LGT.0000000000000061
• Languages: English
• ISSNs: 1089-2591

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective</title> <p>We sought to determine which clinical factors can predict this phenomenon and to better understand the clinical significance of negative loop electrosurgical excision procedure (LEEP) findings through long-term follow-up.</p> </sec> <sec> <title>Methods</title> <p>We identified 559 patients with biopsy-confirmed cervical intraepithelial neoplasia grade 2 or 3 (CIN 2, 3) who were treated by LEEP between February 2001 and December 2010. Preconization clinical characteristics, as well as high-risk human papillomavirus (hrHPV) status, were analyzed as possible predictors of an absence of a lesion in the specimen. The clinical significance of an absence of a lesion in the specimen, as well as other factors, was evaluated by Cox hazard regression analysis in terms of recurrence.</p> </sec> <sec> <title>Results</title> <p>No lesion on the LEEP specimen was found in 102 (18.2%) of 559 patients with CIN 2, 3 on punch biopsy. Punch biopsy status of CIN 2, low HPV viral load (<100 relative light units [RLU]), and negative or positive HPV infection other than type 16 were significantly related to no lesion in the LEEP specimen. Postoperative HPV persistence (≥10 RLU) and same-type HPV detection were significantly related to recurrent disease of CIN 2+ (<italic>p</italic> < .001). The recurrence of patients with no lesion in LEEP did not statistically differ from that of patients with a lesion in the LEEP specimen (<italic>p</italic> = .390).</p> </sec> <sec> <title>Conclusions</title> <p>The absence of a lesion in the LEEP specimen is very common. A negative LEEP is associated with a persistence/recurrence rate similar to that of positive LEEP. We recommend that the follow-up for patients with no lesion in the LEEP specimen should be the same as that for patients with a lesion.</p> </sec> </abstract>