Analysis of outcomes following loop electrosurgical excision and clinical features of patients with cervical high-grade squamous intraepithelial lesions with abnormal preoperative endocervical curettage.
Humans
Female
Uterine Cervical Neoplasms
/ diagnosis
Retrospective Studies
Electrosurgery
/ methods
Papillomavirus Infections
/ complications
Human papillomavirus 16
Neoplasm Recurrence, Local
/ diagnosis
Human papillomavirus 18
Curettage
Squamous Intraepithelial Lesions
/ surgery
Human Papillomavirus Viruses
Papillomaviridae
Endocervical curettage
High-grade squamous intraepithelial lesions
Human papillomavirus
Loop electrosurgical excision procedure
Risk factors
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
03 Aug 2023
03 Aug 2023
Historique:
received:
01
02
2023
accepted:
28
06
2023
medline:
7
8
2023
pubmed:
4
8
2023
entrez:
3
8
2023
Statut:
epublish
Résumé
The purpose of this study was to identify the clinical characteristics of patients with high-grade squamous intraepithelial lesions (HSIL) with abnormal endocervical curettage (ECC) and to evaluate the efficacy of abnormal preoperative ECC in predicting recurrence after a loop electrosurgical excision procedure (LEEP). We retrospectively analyzed a total of 210 cases of histological HSIL in female patients diagnosed using cervical biopsy and/or indiscriminating ECC, and these included 137 cases with normal ECC and 63 cases with abnormal ECC. We also collected preoperative information and data on postoperative human papillomavirus (HPV) and histological outcomes within 2 years. The additional detection rate of HSIL using indiscriminating ECC was 5%. Patients with abnormal ECC were older (P < 0.001), predominantly menopausal (P = 0.001), had high-grade cytology (P = 0.032), a type 3 transformation zone (P = 0.046), and a higher proportion of HPV type 16/18 infection (P = 0.023). Moreover, age (odds ratio [OR] = 1.078, 95% confidence interval [CI] = 1.0325-1.1333, P = 0.003) and HPV 16/18 infection (OR = 2.082, 95% CI = 1.042-4.2163, P = 0.038) were independent risk factors for abnormal ECC. With an observed residual lesion/recurrence rate of 9.5% over the 24-month follow-up, we noted a 9.3% higher rate in the abnormal ECC group when compared with the normal ECC group. Abnormal preoperative ECC (OR = 4.06, 95% CI = 1.09-15.14, P = 0.037) and positive HPV at the 12-month follow-up (OR = 16.55, 95% CI = 3.54-77.37, P = 0.000) were independent risk factors for residual disease/recurrence. Preoperative ECC was one of the risk factors for post-LEEP residual/recurrent HSIL, and detecting abnormal ECC when managing older patients or patients with HPV 16/18 infection during colposcopy is critical.
Identifiants
pubmed: 37537635
doi: 10.1186/s12957-023-03088-5
pii: 10.1186/s12957-023-03088-5
pmc: PMC10399018
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
237Subventions
Organisme : Shanghai Science and Technology Innovation Action Plan
ID : 21S31904200
Organisme : Shanghai Science and Technology Innovation Action Plan
ID : 21S31904200
Organisme : Project of Shanghai Municipal Education Commission--Gaofeng Clinical Medicine Grant Support
ID : 20161412
Organisme : Project of Shanghai Municipal Education Commission--Gaofeng Clinical Medicine Grant Support
ID : 20161412
Organisme : the National Natural Science Foundation of China
ID : 81874101; 82072865
Organisme : the National Natural Science Foundation of China
ID : 81874101; 82072865
Organisme : Clinical Development Fund of Renji Hospital, School of Medicine, Shanghai Jiao Tong University
ID : PY2018-IIA-03
Organisme : Clinical Development Fund of Renji Hospital, School of Medicine, Shanghai Jiao Tong University
ID : PY2018-IIA-03
Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
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