No abstract available.
Cervical Intraepithelial Neoplasia

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

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

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

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

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

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

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: 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

OBJECTIVE: The optimal management of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excisional procedure (LEEP) remains controversial and reliable predictive factors of residual disease after LEEP have not been consistently identified. This study was performed to identify predictive factors for residual disease after LEEP in patients with CIN. METHODS: From June 1996 to May 2000, 166 patients who received subsequent hysterectomy after LEEP according to indication in Dept. of Obstet. and Gynecol. at Chonbuk National University Hospital. The age of patients, the severity of disease, the status of resection margin, and high-risk HPV infection were analyzed for predictive values of residual disease. The student t-test and chi-square test were used for statistical analysis. RESULTS: 1. The residual disease after hysterectomy was negative in 68.1% (113/166) and positive in 31.9% (53/166). 2. The mean age of patients with no residual disease was 45.7 years (range;27-67) and that of patients with residual disease was 49.7 years (range;32-67), showing significant difference (p=0.008). 3. Thirty-three out of 129 cases (25.6%) with negative resection margin and 20 out of 37 cases (54.1%) with positive resection margin in LEEP had residual disease, showing significant difference (p=0.001). 4. Residual disease after hysterectomy was more frequent in patients with more high grade lesions in LEEP, but there was no statistical significant difference (p>0.05). 5. There was no significant difference in the possibility of positive residual disease after hysterectomy between HPV-positive group and HPV-negative group (p=0.84). CONCLUSION: The negative resection margin in LEEP does not always guarantee that there is no residual disease. More aggressive treatment plan (wide conization or hysterectomy) should be considered in patients who has higher possibility of residual disease such as old age and positive resection margin in LEEP.
Cervical Intraepithelial Neoplasia* ; Conization ; Humans ; Hysterectomy ; Jeollabuk-do