학술논문

Is involvement of the surgical margins of large loop excision of the cervical transformation zone specimens for cervical intraepithelial neoplasia III a risk factor for persistent cervical intraepithelial neoplasia?
Document Type
Academic Journal
Author
Keen CE; Department of Histopathology, University Hospital Lewisham, London, UK.; Pandey UPhilip GSmeeton NC
Source
Publisher: Informa Healthcare Country of Publication: England NLM ID: 8309140 Publication Model: Print Cited Medium: Print ISSN: 0144-3615 (Print) Linking ISSN: 01443615 NLM ISO Abbreviation: J Obstet Gynaecol Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
0144-3615
Abstract
We aimed to test the hypothesis that patients with cervical intraepithelial neoplasia (CIN) III treated by large loop excision of the cervical transformation zone (LLETZ) are more likely to suffer recurrence of cervical abnormalities if the CIN reaches the margins of the index specimen. Three hundred and forty-five women treated by LLETZ in 1991, and 1992, and in whom the histological diagnosis was CIN III, were studied. The reports were reviewed and the cases were categorised as completely excised, incompletely excised, or undetermined. Cytological follow-up, or in some cases histological follow-up in the same year and in each of the 5 following years was tabulated. Follow-up data were recorded from the same and also surrounding institutions. The chi-squared test was used to compare the differences in recurrence rates between the three groups at the various points in time. A small advantage was demonstrated for those cases where excision was complete. This was statistically significant in the third following year (P=0.022). The resection margin status of LLETZ specimens for CIN III has only a minor effect on the likelihood of recurrence. Nevertheless, recording the status may be important in case of unexpected invasion. The relative reassurance the information will provide when the lesion has been excised may also be seen as worthwhile.