No abstract available.
Cervical Intraepithelial Neoplasia

No abstract available.
Cervical Intraepithelial Neoplasia* ; Statistics as Topic*

No abstract available.
Cervical Intraepithelial Neoplasia* ; Colposcopy* ; Conization*

OBJECTIVE: The aim of this study was to identify human papillomavirus (HPV) in cervical intraepithelial neoplasia (CIN) and to evaluate the persistence of HPV after loop electrosurgical excision precedure (LEEP). METHODS: Records of 138 patients with LEEP performed due to cervicitis, CIN I, CIN II and CIN III were reviewed and persistence of HPV were followed up at 3, 6, 9 and 12 month after LEEP treatment from January 1996 to December 1999. RESULTS: Among 202 patients, 138 cases (68.3%) were showed HPV positive before LEEP and histologic findings were showed as cervicitis 20 cases (14.5%), CIN I 23 cases (16.7%), CIN II 31 cases (22.5%) and CIN III 64 cases (46.3%). Persistence of HPV after LEEP treatment were 10.9% (15/138) at 3 month and 2.9% (4/138) at 6 month. However, among 15 cases of persistent HPV, only 5 cases (33.3%) were showed an abnormal Pap smear at 3 month after LEEP. CONCLUSION: Human papillomavirus (HPV) was eliminated over 90% at 3 month after LEEP treatment in CIN. Detection of HPV was helpful to estimate therapeutic effect and to predict the recurrence or persistence of CIN after LEEP treatment.
Cervical Intraepithelial Neoplasia* ; Humans ; Recurrence ; Uterine Cervicitis

The carcinoma of uterine cervix is the most common malignant neoplasm in Korean women. Nearly all invasive cervical carcinomas are preceded by a intraepithelial stage. The cervical intraepithelial lesion(CIN) is subdivided into I, II, and III, depending on the severity of the changes. To evaluate the histologic characteristics of the CIN, we studied the CIN III by mapping of the uterine cervix. The results were as follows. 1. The CIN III without I or II was 54.8%(17/31 cases). 2. The multifocal CIN III was 12.9%(4/31 cases). 3. The horizontal growth of CIN III was 38.7%(12/31 cases). These results indicate that the CIN III is unifocal and CIN III without I or II is more common.
Cervical Intraepithelial Neoplasia* ; Cervix Uteri* ; Female ; Humans

No abstract available.
Cervical Intraepithelial Neoplasia* ; Cervix Uteri* ; Diagnosis* ; Female

OBJECTIVE: To examine the correlation between cervical cytology and final histological results in patients who have undergone loop electrosurgical excision procedure (LEEP) with or without colposcopy-directed biopsy. METHODS: A retrospective review was performed of 829 patients who underwent LEEP for abnormal cervical cytology at Gangnam Severance Hospital between January 2004 and December 2008. Patients were classified to three groups according to cervical cytology and also divided into two groups based on the treatment they received: see-and-treat group and the standard three-step group. Final histological results were compared for the each study group. RESULTS: There were no differences in the final histological results between see-and-treat and three-step group in patients with high-grade squamous intraepithelial lesions (HSIL) cytology (N=523) (p=0.71). However, in patients with low-grade squamous intraepithelial lesions (LSIL)/atypical squamous cells of undetermined significance (ASCUS) (N=257) or normal cytology (N=49), the final histological results were significantly different between see-and-treat and three-step group (p<0.001) and the rate of overtreatment was significantly higher in the see-and-treat group (p<0.001). CONCLUSION: A see-and-treat protocol may be a viable alternative only in patients with HSIL cytology if colposcopic impression is suggestive of cervical intraepithelial neoplasia (CIN) 2 or 3 lesions.
Biopsy ; Cervical Intraepithelial Neoplasia ; Humans ; Retrospective Studies

OBJECTIVE: To evaluate Fragile histidine triad (Fhit) and p53 expression pattern in cervical intraepithelial neoplasm (CIN) and invasive cervical cancer, and to verify the correlation between the loss of Fhit and clinicopathological parameters of invasive cervical carcinoma and the relationship between Fhit and p53 expression. METHODS: 10 low-grade squamous intraepithelial lesions (LSIL), 16 high-grade squamous intraepithelial lesions (HSIL), and 21 invasive cervical carcinomas were evaluated by immunohistochemical staining for Fhit and p53 primary antibody. Their expression patterns in CIN and invasive cervical cancer were analysed semiquantitatively as positive and negative by the staining area and intensity. Clinicopathological data were obtained by review of patients' hospital records. RESULTS: Compared with CIN (LSIL and HSIL), invasive cervical carcinoma showed significantly loss of Fhit expression (p<0.05). P53 expression did not show the significant difference between CIN and invasive cervical cancer. There was no relationship between loss of Fhit and p53 expression in CIN and invasive cervical cancer. But loss of Fhit expression in invasive cervical cancer was also significantly associated with FIGO stage (p<0.05). CONCLUSION: Our results suggest that loss of Fhit expression may play an important role in the malignant transformation of CIN to invasive cancer. However, further molecular studies are needed to elucidate the role of Fhit gene in the carcinogenesis of cervical cancer.
Carcinogenesis ; Cervical Intraepithelial Neoplasia* ; Histidine ; Hospital Records ; Uterine Cervical Neoplasms*

OBJECTIVE: The aim of this study is to evaluate the clinical usefulness of cervicogram as primary screening test of cervical intraepithelial neoplasia. METHODS: Total 294 women who had undergone cervicogram and pathologically diagnosed at YUMC between January and July 2003, were selected. Diagnostic accuracy of Pap smear, cervicogram and Pap smear combined with cervicogram were compared with pathologic diagnosis. Statistical analysis was performed by chi-square test (SPSS version 11.0). RESULTS: 1. Among 294 women, Pap smears were normal in 130 cases (44.2%) and abnormal in 164 cases (55.8%). The diagnostic accuracy between Pap smear and histology was as follows; sensitivity 72.0%, specificity 64.6%, positive predictive value 72.0%, negative predictive value 64.6%, false positive rate 28.0%, false negative rate 35.4%. 2. Cervicogram were normal in 202 cases (68.7%) and abnormal in 92 cases (31.3%). The diagnostic accuracy between cervicogram and histology was as follows; sensitivity 39.6%, specificity 79.2%, positive predictive value 70.7%, negative predictive value 31.0%, false positive rate 29.3%, false negative rate 49.0%. 3. Among 130 women with normal Pap smear, cervicogram were normal in 101 cases (77.7%) and abnormal in 29 cases (22.3%). The diagnostic accuracy between cervicogram with normal Pap smear and histology was as follows; sensitivity 26.1%, specificity 79.8%, positive predictive value 41.4%, negative predictive value 66.3%, false positive rate 58.6%, false negative rate 33.7%. 4. Among 164 women with abnormal Pap smear, Cervicograms were normal in 101 cases (61.6%) and abnormal in 63 cases (38.4%). The diagnostic accuracy between cervicogram with abnormal Pap smear and histology was as follows; sensitivity 44.9%, specificity 78.3%, positive predictive value 84.1%, negative predictive value 32.7%, false positive rate 15.9%, false negative rate 67.3%. CONCLUSION: Although adjunctive use of cervicogram to Pap smear in initial screening of cervical intraepithelial neoplasia showed higher specificity, higher negative predictive value and lower false negative rate compared to Pap smear alone, but, consideration in terms of lower sensitivity, lower positive predictive value, higher false positive rate and cost-effectiveness should be given in lieu of clinically applicating cervicogram with Pap smear as initial screening test.
Cervical Intraepithelial Neoplasia* ; Diagnosis ; Female ; Humans ; Mass Screening* ; Sensitivity and Specificity

OBJECTIVE: To evaluate the efficacy of loop electrosurgical excision procedure (LEEP) combined with cold coagulation for treating cervical intraepithelial neoplasia (CIN). METHODS: We reviewed clinic-pathologic data of 498 patients treated with LEEP alone (n=354), and LEEP combined with cold coagulation (n=144) between January 2000 and December 2011. After LEEP, we followed up all patients by using Papanicolaou smear and human papillomavirus (HPV) test, and evaluated abnormal cervical cytology-free interval and high-risk HPV infection-free interval. Moreover, we investigated independent factors affecting abnormal cervical cytology or high-risk HPV infection after LEEP. RESULTS: Abnormal cervical cytology-free interval was longer in patients treated with LEEP combined with cold coagulation than in those treated with LEEP alone (mean, 92.4 vs. 84.4 months; P=0.01), and patients treated with LEEP combined with cold coagulation also showed longer high-risk HPV infection-free interval than those treated with LEEP alone (mean, 87.6 vs. 59.1 months; P=0.01). Moreover, CIN 3 and cold coagulation were factors affecting abnormal cervical cytology after LEEP (adjusted hazard ratios, 1.90 and 0.61; 95% confidence intervals, 1.27 to 2.84 and 0.39 to 0.96), and CIN 3, positive deep cervical margin and cold coagulation were also factors affecting high-risk HPV infection after LEEP (adjusted hazard ratios, 2.07, 4.11, and 0.64; 95% confidence intervals, 1.38 to 3.08, 1.63 to 10.39, and 0.43 to 0.96). When we performed subgroup analyses for patients with CIN 2 or CIN 3, the result were similar. CONCLUSION: LEEP combined with cold coagulation may be more effective for treating CIN than LEEP alone. Moreover, cold coagulation may decrease the risk of potential of recurrence after LEEP.
Cervical Intraepithelial Neoplasia* ; Cohort Studies* ; Humans ; Papanicolaou Test ; Recurrence