Routine follow-up intervals in patients with high-grade squamous intraepithelial lesions (HSIL) and free excision margins can safely be increased in the first two years after Large Loop Excision of the Transformation Zone (LLETZ)

Aims and background The purpose of this study was to assess the association between highly-oncogenic types HPV DNA detection by Hybrid Capture II (HCII) and residual or recurrent high-grade cervical intraepithelial neoplasia (CIN 2 or 3) during the follow-up of women submitted to large loop excision of the transformation zone (LLETZ). Study design In this cohort study, 94 women submitted to LLETZ because of CIN 2 or 3 between March 2001 and September 2002 were followed up twice yearly until September 2003. Follow-up visits consisted of an interview regarding clinical, social and demographic characteristics complemented with gynecological examination with specimen collection for Pap test and HCII and colposcopy. Eighty-one patients attended the first visit (mean 4.8 months, range 3-6) and 75 the second visit (mean 10.9 months, range 7-17 months). McNemar's test to assess the variation of HPV DNA detection following LLETZ, odds ratios (OR) to evaluate the correlation between HPV DNA positivity and residual/recurrent CIN during follow-up, and logistic regression to assess the risk of residual/recurrent CIN were used. Results There was a strong and significant reduction in HPV detection after LLETZ ( P <0.001). HPV DNA detection was correlated with residual/recurrent CIN at the first (OR = 103.4; 95% CI 5.5 to 1961.2) and second (OR = 12.7; 95% CI 1.1 to 345.5) follow-up visits. Multivariate analysis showed HPV persistence as a stand-alone risk factor for residual/recurrent CIN (OR = 50.3; 95% CI 3.8 to 663.1). Conclusions High risk HPV DNA detection decreased substantially after CIN treatment with LLETZ, but HPV persistence was strongly correlated with residual/recurrent CIN.

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Infections with Multiple High-risk Human Papillomavirus (HPV) Types are Associated with More High-grade Squamous Intraepithelial Lesions (HSIL) on Follow-up Cervical Biopsy

Journal of the American Society of Cytopathology ◽

10.1016/j.jasc.2017.06.065 ◽

2017 ◽

Vol 6 (5) ◽

pp. S26-S27

Author(s):

Remegio Maglantay ◽

Brenda Sweeney ◽

Ivan Chebib ◽

David Wilbur

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

High Grade ◽

Squamous Intraepithelial Lesions ◽

Cervical Biopsy ◽

Hpv Types ◽

Intraepithelial Lesions

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Association of Bacterial Vaginosis and Human Papilloma Virus Infection With Cervical Squamous Intraepithelial Lesions

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz021 ◽

2019 ◽

Vol 152 (2) ◽

pp. 185-189 ◽

Cited By ~ 2

Author(s):

Wissam Dahoud ◽

Claire W Michael ◽

Hamza Gokozan ◽

Amelia K Nakanishi ◽

Aparna Harbhajanka

Keyword(s):

Bacterial Vaginosis ◽

Human Papilloma Virus Infection ◽

Hpv Infection ◽

High Grade ◽

Squamous Intraepithelial Lesions ◽

Papilloma Virus ◽

Cervical Squamous Intraepithelial Lesions ◽

The Relationship ◽

Intraepithelial Lesions

ABSTRACT Objectives Human papillomavirus (HPV) is known to be associated with squamous intraepithelial lesions (SILs). However, there is limited and conflicting literature on the relationship between bacterial vaginosis (BV) and SIL. The aim of this study is to determine the prevalence of BV and evaluate the association between BV and SIL. Methods A retrospective study was performed on 10,546 cases between 2012 and 2017. HPV results were available in 7,081 cases. Results BV was present in 17.6% of cases. There was significant association between BV, positive HPV infection, and high-grade SIL. BV patients with negative HPV infection showed more squamous abnormalities than BV-negative HPV-negative patients. Conclusions We found there is a significant association between BV and SIL. BV is more common among patients with HPV infection and is independently associated with squamous abnormalities in cervical smears and surgical follow-up.

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Human Papilloma Virus Persistence after Cone Excision in Women with Cervical High Grade Squamous Intraepithelial Lesion: A Prospective Study

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2016/3076380 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Laurențiu Pirtea ◽

Dorin Grigoraş ◽

Petru Matusz ◽

Marilena Pirtea ◽

Lavinia Moleriu ◽

...

Keyword(s):

Prospective Study ◽

Pap Smear ◽

Hpv Infection ◽

High Grade ◽

Transformation Zone ◽

Large Loop ◽

Persistence Rate ◽

Intraepithelial Lesion ◽

A Prospective Study ◽

Intraepithelial Lesions

Background. Persistent human papillomavirus (HPV) infection is a necessary event in cervical cancer tumorigenesis. Our objectives were to estimate the rate of HPV infection persistence after large loop excision of the transformation zone (LEEP) in patients with high grade squamous intraepithelial lesions (HSIL) and to investigate if HPV persistence is type related.Methods. We conducted a prospective study on 89 patients with HSIL treated with LEEP. DNA HPV was performed before surgery and at 6, 12, and 18 months after LEEP.Results. Four patients were excluded from the study. The HPV persistence in the remaining 85 patients was 32.95% (6 months), 14.12% (12 months), and 10.59% (18 months). Type 16 had the highest persistence rate, 23.5% (6 months), 11.8% (12 months), and 8.2% (18 months). Coinfection was found to be 54.12% before LEEP and 18.8% (6 months), 4.7% (12 months), and 3.5% (18 months) after LEEP. The rate of coinfections including type 16 was 46.83% of all coinfections. Coinfection including type 16 was not correlated with higher persistence rate compared to infection with type 16 only.Conclusions. HPV infection is not completely eradicated by LEEP in patients with HSIL lesion on PAP smear. HPV persistence after LEEP is influenced by HPV type. HPV type 16 has the highest persistence rate.

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Follow-up of women with atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H)

Sao Paulo Medical Journal ◽

10.1590/1516-3180.2014.1321597 ◽

2014 ◽

Vol 132 (1) ◽

pp. 15-22 ◽

Cited By ~ 1

Author(s):

Fanny Lopez-Alegria ◽

Dino Soares De Lorenzi ◽

Orlando Poblete Quezada

Keyword(s):

Primary Healthcare ◽

Lesion Detection ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesions ◽

Squamous Cells ◽

The Times ◽

Primary Healthcare Clinics ◽

Intraepithelial Lesions

CONTEXT AND OBJECTIVE: The concept that the presence of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H) was introduced in the 2001 Bethesda System of cervical cytology classification. This nomenclature defines cervical cancer precursor lesions. The objective of this study was to investigate the colpocytological-histological results from a three-year follow-up conducted on a cohort of women with reports of ASC-H who were attended during 2005-2006 at clinics of the Southern Metropolitan Healthcare Service of Santiago, Chile. DESIGN AND SETTING: Prospective cohort study at primary healthcare clinics in Santiago, Chile. METHODS : Colpocytological-histological follow-up was conducted over a three-year period on 92 women with cytological reports of ASC-H who were attended at primary healthcare clinics during 2005-2006. RESULTS : At the end of the follow-up period, high-grade lesions were evaluated and the following outcomes were observed: seven women presented invasive cancer (7.6%), 49 presented high-grade lesions (53.3%), 26 presented low-grade lesions (28.2%) and 10 presented normal results (10.9%). The "Conditional Probabilities Tree Diagram" was used to show the results from tests and the times of lesion detection. It demonstrated that, after a first report of ASC-H, clinical management needed to be interventionist. CONCLUSION: The follow-up on our cohort of women showed that the majority of uncertain ASC-H diagnoses (82.6%) had abnormal colposcopic results and that during the follow-up using ASC-H smears, two out of every three women developed high-grade lesions.

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