Predictive Factors Involved in Postpartum Regressions of Cytological/Histological Cervical High-Grade Dysplasia Diagnosed during Pregnancy

Objective: The aim of this study was to describe the evolution of high-grade cervical dysplasia during pregnancy and the postpartum period and to determine factors associated with dysplasia regression. Methods: Pregnant patients diagnosed with high-grade lesions were identified in our tertiary hospital center. High-grade lesions were defined either cytologically, by high squamous intraepithelial lesion/atypical squamous cells being unable to exclude HSIL (HSIL/ASC-H), or histologically, with cervical intraepithelial neoplasia (CIN) 2+ (all CIN 2 and CIN 3) during pregnancy. Postpartum regression was defined cytologically or histologically by at least a one-degree reduction in severity from the antepartum diagnosis. A logistic regression model was applied to determine independent predictive factors for high-grade cervical dysplasia regression after delivery. Results: Between January 2000 and October 2017, 79 patients fulfilled the inclusion criteria and were analyzed. High-grade cervical lesions were diagnosed by cytology in 87% of cases (69/79) and confirmed by histology in 45% of those (31/69). The overall regression rate in our cohort was 43% (34/79). Univariate analysis revealed that parity (p = 0.04), diabetes (p = 0.04) and third trimester cytology (p = 0.009) were associated with dysplasia regression. Nulliparity (OR = 4.35; 95%CI = (1.03–18.42); p= 0.046) was identified by multivariate analysis as an independent predictive factor of high-grade dysplasia regression. The presence of HSIL on third-trimester cervical cytology (OR = 0.17; 95%CI = (0.04–0.72); p = 0.016) was identified as an independent predictive factor of high-grade dysplasia persistence at postpartum. Conclusion: Our regression rate was high, at 43%, for high-grade cervical lesions postpartum. Parity status may have an impact on dysplasia regression during pregnancy. A cervical cytology should be performed at the third trimester to identify patients at risk of CIN persistence after delivery. However, larger cohorts are required to confirm these results.

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p16INK4a is superior to high-risk human papillomavirus testing in cervical cytology for the prediction of underlying high-grade dysplasia

Cancer Cytopathology ◽

10.1002/cncy.20078 ◽

2010 ◽

Vol 118 (3) ◽

pp. 146-156 ◽

Cited By ~ 28

Author(s):

Panduka Samarawardana ◽

Donna L. Dehn ◽

Meenakshi Singh ◽

Douglas Franquemont ◽

Chesney Thompson ◽

...

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Cervical Cytology ◽

High Grade Dysplasia ◽

High Grade ◽

Human Papillomavirus Testing

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The Role of Early Colposcopy in the Management of Females with First Episode Anogenital Warts

International Journal of STD & AIDS ◽

10.1177/095646249400500511 ◽

1994 ◽

Vol 5 (5) ◽

pp. 343-345 ◽

Cited By ~ 2

Author(s):

K A Ward ◽

J R Houston ◽

B E Lowry ◽

R D Maw ◽

W W Dinsmore

Keyword(s):

Intraepithelial Neoplasia ◽

Hpv Infection ◽

Cervical Cytology ◽

First Episode ◽

Low Grade ◽

High Grade ◽

Anogenital Warts ◽

Cervical Smear ◽

Cervical Lesions ◽

Increased Risk

212 females attending a genitourinary medicine (GUM) clinic with first episode anogenital warts were screened by cervical cytology and colposcopy/histology for the presence of cervical epithelial abnormalities in keeping with infection by the human papillomavirus (HPV infection) and/or cervical intraepithelial neoplasia (CIN). The prevalence of cervical epithelial abnormalities detected by cervical cytology alone was 32%, rising to 56% after colposcopic examination. However, the majority of cervical lesions detected by colposcopy alone were of low grade (HPV infection and/or CIN I). Histologically confirmed high grade cervical lesions (CIN II or CIN III) were detected more frequently in those females in whom cervical cytological examination indicated dyskaryosis in keeping with any grade of CIN, compared to females without dyskaryotic changes on cervical smear ( P<0.05, chi-squared test with Yates' correction). Early colposcopy is indicated for females with anogenital warts in the presence of a cervical smear showing dyskaryosis in keeping with any grade of CIN, because of the statistically significant increased risk of detecting a potentially progressive high grade cervical lesion. In females without dyskaryotic changes on cervical smear, the value of early colposcopy is uncertain and warrants larger more long-term trials.

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Human papillomavirus and abnormal cervical lesions among HIV-infected women in HIV-discordant couples from Kenya

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-054052 ◽

2020 ◽

Vol 96 (6) ◽

pp. 457-463 ◽

Cited By ~ 1

Author(s):

Brandon L Guthrie ◽

Anne F Rositch ◽

Joy Alison Cooper ◽

Carey Farquhar ◽

Rose Bosire ◽

...

Keyword(s):

Human Papillomavirus ◽

Hpv Infection ◽

Cervical Neoplasia ◽

Cervical Cytology ◽

High Grade ◽

Cervical Lesions ◽

Hpv Prevalence ◽

High Grade Lesion ◽

Hpv Types ◽

Hpv Screening

ObjectiveHIV infection increases the risk of high-grade cervical neoplasia and invasive cervical carcinoma. The study addresses the limited data describing human papillomavirus (HPV) infection and cervical neoplasia among HIV-infected women in HIV-discordant relationships in sub-Saharan Africa, which is needed to inform screening strategies.MethodsA cross-sectional study of HIV-infected women with HIV-uninfected partners was conducted to determine the distribution of type-specific HPV infection and cervical cytology. This study was nested in a prospective cohort recruited between September 2007 and December 2009 in Nairobi, Kenya. Cervical cells for HPV DNA testing and conventional cervical cytology were collected. HPV types were detected and genotyped by Roche Linear Array PCR assay.ResultsAmong 283 women, the overall HPV prevalence was 62%, and 132 (47%) had ≥1 high-risk (HR)-HPV genotype. Of 268 women with cervical cytology results, 18 (7%) had high-grade cervical lesions or more severe by cytology, of whom 16 (89%) were HR-HPV-positive compared with 82 (41%) of 199 women with normal cytology (p<0.001). The most common HR-HPV types in women with a high-grade lesion or more severe by cytology were HPV-52 (44%), HPV-31 (22%), HPV-35 (22%), HPV-51 (22%) and HPV-58 (22%). HR-HPV genotypes HPV-16 or HPV-18 were found in 17% of women with high-grade lesions or more severe. HR-HPV screening applied in this population would detect 89% of those with a high-grade lesion or more severe, while 44% of women with normal or low-grade cytology would screen positive.ConclusionHR-HPV prevalence was high in this population of HIV-infected women with an uninfected partner. Choice of screening for all HR genotypes versus a subset of HR genotypes in these HIV-infected women will strongly affect the performance of an HPV screening strategy relative to cytological screening. Regional and subpopulation differences in HR-HPV genotype distributions could affect screening test performance.

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Predictors of Human papillomavirus (HPV) persistence after treatment of high grade cervical lesions; does cervical cytology have any prognostic value in primary HPV screening?

Annals of Diagnostic Pathology ◽

10.1016/j.anndiagpath.2020.151626 ◽

2020 ◽

Vol 49 ◽

pp. 151626 ◽

Cited By ~ 1

Author(s):

Derya Kilic ◽

Tolga Guler ◽

Ayhan Atigan ◽

Elif Avsaroglu ◽

Yeliz Arman Karakaya ◽

...

Keyword(s):

Human Papillomavirus ◽

Prognostic Value ◽

Cervical Cytology ◽

High Grade ◽

Cervical Lesions ◽

Hpv Screening

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High Rates of High-Grade Cervical Dysplasia in High-Risk Young Women With Low-Grade Cervical Cytology

Journal of Lower Genital Tract Disease ◽

10.1097/lgt.0000000000000381 ◽

2018 ◽

Vol 22 (3) ◽

pp. 207-211 ◽

Cited By ~ 2

Author(s):

Laura R. Daily ◽

Britt K. Erickson ◽

Daniel N. Pasko ◽

J. Michael Straughn ◽

Warner K. Huh ◽

...

Keyword(s):

High Risk ◽

Young Women ◽

Cervical Dysplasia ◽

Cervical Cytology ◽

Low Grade ◽

High Grade

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Inflammatory Blood Markers as Prognostic and Predictive Factors in Early Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Cancers ◽

10.3390/cancers12092666 ◽

2020 ◽

Vol 12 (9) ◽

pp. 2666

Author(s):

Ileana Corbeau ◽

Simon Thezenas ◽

Aurelie Maran-Gonzalez ◽

Pierre-Emmanuel Colombo ◽

William Jacot ◽

...

Keyword(s):

Breast Cancer ◽

Prognostic Factor ◽

Febrile Neutropenia ◽

Early Breast Cancer ◽

Predictive Factors ◽

Predictive Factor ◽

Pathological Complete Response ◽

Complete Response ◽

Independent Predictive Factor ◽

Lymphocyte Ratio

Background: Inflammatory blood markers, such as neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), have been reported as putative prognostic factors for survival and predictive factors for pathological complete response and toxicity in cancers, however with conflicting results. Methods: We retrospectively analyzed data of 280 patients with early breast cancer receiving neo-adjuvant chemotherapy between 2005 and 2013 in our center. Neutrophil count, lymphocyte count and platelet count before treatment were collected as well as data on pathological complete response, toxicity, recurrence and survival. Results: In multivariate analysis, high PLR was an independent prognostic factor for relapse-free survival (hazard ratio [HR] = 1.91; 95%CI = 1.15–3.16; p = 0.012) and for shorter overall survival (HR = 1.83; 95%CI = 1.03–3.24; p = 0.039). NLR was an independent predictive factor for febrile neutropenia (HR = 0.28; 95%CI = 0.13–0.58; p = 0.001). In triple negative breast cancer molecular subtype, low white blood cell count (<6.75 G/L) was predictive for a higher pathological complete response rate (odds ratio [OR] = 0.29; 95%CI = 0.14–0.61; p < 0.01). Conclusion: In the present study, PLR was found as an independent prognostic factor for survival, while NLR was an independent predictive factor for febrile neutropenia.

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Outcome in women with no endocervical component on cervical cytology after treatment for high-grade cervical dysplasia

Australian and New Zealand Journal of Obstetrics and Gynaecology ◽

10.1111/j.1479-828x.2009.01014.x ◽

2009 ◽

Vol 49 (4) ◽

pp. 426-428 ◽

Cited By ~ 8

Author(s):

Alice HUANG ◽

Michael QUINN ◽

Jeffrey TAN

Keyword(s):

Cervical Dysplasia ◽

Cervical Cytology ◽

High Grade

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Management of Abnormal Cervical Cytology: Atypical Squamous Cells of Undetermined Significance (ASC-US) and Atypical Squamous Cells cannot exclude High Grade Intraepithelial Lesion (ASC-H)

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v1i3.359 ◽

2016 ◽

pp. 166-170

Author(s):

Fitriyadi Kusuma ◽

Mediana S. Liedapraja

Keyword(s):

Cervical Cytology ◽

Low Grade ◽

High Grade ◽

Cervical Lesions ◽

Squamous Cells ◽

Abnormal Cervical Cytology ◽

Definitive Therapy ◽

Intraepithelial Lesion ◽

Precancerous Cervical Lesions ◽

Undetermined Significance

Objective: To review for the management of abnormal cervical cytology: atypical squamous cells of undetermined significance (ASCUS) and atypical squamous cells cannot exclude high-grade intraepithelial lesion (ASC-H) as a treatment of cervical precancerous lesions in order to avoidexcessive treatment, reduce of unnecessary examinations and to provide cost effectively. Method: Literature study on published literatures and studies about the management of cervical cytology. Conclusion: The results of ASC-US cervical cytology and ASC-H is aninitial screening to detect precancerous cervical lesions. Definitive therapy should be done when finding a low-grade lesions (LSIL) and high degree of lesion(HSIL) squamous intraepithelial. A clinician expected to understand the natural history of HPV infection and the management of precancerous cervical lesions properly. [Indones J Obstet Gynecol 2013; 37-3: 166-170] Keywords: ASC-H, ASC-US, cervical cytology abnormalities, cervical precancerous lesion.

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