1. Conservative management of cervical intraepithelial neoplasia 2 and prediction of its progression - a retrospective study.
- Author
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Cărăuleanu A, Mogoş RA, Solomon-Condriuc IP, Costea CF, Cucu AI, Bran ŞR, Tănase AE, Tănase GV, Pruteanu EA, Socolov DG, Petrariu FD, and Buzdugă CM
- Subjects
- Humans, Female, Retrospective Studies, Adult, Case-Control Studies, Conservative Treatment methods, Uterine Cervical Neoplasms pathology, Uterine Cervical Neoplasms virology, Uterine Cervical Neoplasms diagnosis, Middle Aged, Uterine Cervical Dysplasia virology, Uterine Cervical Dysplasia pathology, Uterine Cervical Dysplasia diagnosis, Disease Progression
- Abstract
Aim: Cervical intraepithelial neoplasia 2 (CIN2) evolution is controversial, and some of them regress spontaneously in a two-year follow-up. The purpose of this work was to evaluate the percentage of CIN2 progression or persistence during a 24-month follow-up, using clinical predictors such as human papillomavirus (HPV) genotype and cytology results., Patients, Materials and Methods: This is a retrospective case-control study and included patients of reproductive age who had a new diagnosis of CIN2 who were monitored for lesion regression (Group 1, n=72 patients), and progression or persistence (Group 2, n=36 patients). A multinominal logistic regression was preferred to evaluate the impact that various categorical risk elements can lead to outcomes of persistence or progression of CIN2. We also performed a linear regression to assess the risk of CIN2 progression or persistence using the interaction between clinical predictors., Results: A previous cervical cytology indicative of high-grade squamous intraepithelial lesion (HSIL) [relative risk ratio (RRR): 3.85, 95% confidence interval (CI): 1.66-8.90] or atypical squamous cells, cannot exclude HSIL (ASC-H) can highly raise the probability of a CIN2 progression or persistence. The presence of HPV16 increased the risk of CIN2+ with 3.77 (95% CI: 0.78-5.00), the presence of HPV18 increased the probability of CIN2+ with 4.39 (95% CI: 1.35-14.33), and other high-risk HPV (HR-HPV) strains increased the probability of CIN2+ with 3.62. The highest risk issue was produced by the interaction between HSIL* HPV16, ASC-H* HPV16, and ASC-H* HPV18., Conclusions: When discussing follow-up for CIN2 lesions, it is important to offer careful consideration and monitoring of patients with a previous HSIL or ASC-H cytology, with or without HPV 16, 18 or other HR-HPV strains, as their presence significantly increased the risk of CIN2 progression and persistence., Competing Interests: The authors declare that they have no conflict of interests. more...
- Published
- 2024
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