Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing
Objective. To investigate conservative and excisional/ablative treatment outcomes for cervical intraepithelial neoplasia grade 2 (CIN2) following introduction of virological test of cure. Methods. This was a retrospective study of prospectively collected data at a teaching hospital colposcopy unit....
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Obstetrics and Gynecology International |
| Online Access: | http://dx.doi.org/10.1155/2022/7955290 |
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| author | Kevin Dominique Tjandraprawira Adeola Olaitan Aviva Petrie Nafisa Wilkinson Adam N. Rosenthal |
| author_facet | Kevin Dominique Tjandraprawira Adeola Olaitan Aviva Petrie Nafisa Wilkinson Adam N. Rosenthal |
| author_sort | Kevin Dominique Tjandraprawira |
| collection | DOAJ |
| description | Objective. To investigate conservative and excisional/ablative treatment outcomes for cervical intraepithelial neoplasia grade 2 (CIN2) following introduction of virological test of cure. Methods. This was a retrospective study of prospectively collected data at a teaching hospital colposcopy unit. 331 sequential biopsy-proved CIN2 cases were involved. CIN2 cases diagnosed between 01/07/2014 and 31/12/2017 were either conservatively managed or treated with excision/ablation and then were followed up until discharge from colposcopy clinic and then using the national cervical cytology database. Outcomes were defined: cytological/histological regression was absence of high-grade CIN on biopsy and/or high-grade dysplasia; virological regression was cytological/histological regression and negative human papillomavirus testing; persistence was biopsy-proven CIN2 and/or moderate dyskaryosis; progression was biopsy-proven CIN3+ and/or severe dyskaryosis. Results. Median follow-up was 22.6 months (range: 1.9–65.1 months). Among 175 (52.9%) patients initially managed conservatively, 77.3% (133/172) regressed, 13.4% (23/172) persisted, 9.3% (16/172) progressed to CIN3+, and 97 (56.4%) patients achieved virological regression. 156 (47.1%) patients underwent initial excision/ablation, with an 89.4% (110/123) virological cure rate. After discharge, 7 (4.0%) and 3 (1.9%) patients redeveloped CIN in the conservative and treatment groups, respectively, during a median period of 17.2 months. Conclusion. Conservative management is a reasonable and effective management strategy in appropriately selected women with CIN2. High rates of histological and virological regression should be expected. The previously mentioned data provide useful information for deciding management options. |
| format | Article |
| id | doaj-art-261ad6ce595c4cfbaa3f3d6a36724bc8 |
| institution | Kabale University |
| issn | 1687-9597 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Obstetrics and Gynecology International |
| spelling | doaj-art-261ad6ce595c4cfbaa3f3d6a36724bc82025-02-03T06:01:52ZengWileyObstetrics and Gynecology International1687-95972022-01-01202210.1155/2022/7955290Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV TestingKevin Dominique Tjandraprawira0Adeola Olaitan1Aviva Petrie2Nafisa Wilkinson3Adam N. Rosenthal4Elizabeth Garrett Anderson’s Institute for Women’s HealthUniversity College London Hospitals NHS TrustEastman Dental InstituteUniversity College London Hospitals NHS TrustElizabeth Garrett Anderson’s Institute for Women’s HealthObjective. To investigate conservative and excisional/ablative treatment outcomes for cervical intraepithelial neoplasia grade 2 (CIN2) following introduction of virological test of cure. Methods. This was a retrospective study of prospectively collected data at a teaching hospital colposcopy unit. 331 sequential biopsy-proved CIN2 cases were involved. CIN2 cases diagnosed between 01/07/2014 and 31/12/2017 were either conservatively managed or treated with excision/ablation and then were followed up until discharge from colposcopy clinic and then using the national cervical cytology database. Outcomes were defined: cytological/histological regression was absence of high-grade CIN on biopsy and/or high-grade dysplasia; virological regression was cytological/histological regression and negative human papillomavirus testing; persistence was biopsy-proven CIN2 and/or moderate dyskaryosis; progression was biopsy-proven CIN3+ and/or severe dyskaryosis. Results. Median follow-up was 22.6 months (range: 1.9–65.1 months). Among 175 (52.9%) patients initially managed conservatively, 77.3% (133/172) regressed, 13.4% (23/172) persisted, 9.3% (16/172) progressed to CIN3+, and 97 (56.4%) patients achieved virological regression. 156 (47.1%) patients underwent initial excision/ablation, with an 89.4% (110/123) virological cure rate. After discharge, 7 (4.0%) and 3 (1.9%) patients redeveloped CIN in the conservative and treatment groups, respectively, during a median period of 17.2 months. Conclusion. Conservative management is a reasonable and effective management strategy in appropriately selected women with CIN2. High rates of histological and virological regression should be expected. The previously mentioned data provide useful information for deciding management options.http://dx.doi.org/10.1155/2022/7955290 |
| spellingShingle | Kevin Dominique Tjandraprawira Adeola Olaitan Aviva Petrie Nafisa Wilkinson Adam N. Rosenthal Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing Obstetrics and Gynecology International |
| title | Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing |
| title_full | Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing |
| title_fullStr | Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing |
| title_full_unstemmed | Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing |
| title_short | Comparison of Expectant and Excisional/Ablative Management of Cervical Intraepithelial Neoplasia Grade 2 (CIN2) in the Era of HPV Testing |
| title_sort | comparison of expectant and excisional ablative management of cervical intraepithelial neoplasia grade 2 cin2 in the era of hpv testing |
| url | http://dx.doi.org/10.1155/2022/7955290 |
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