Evaluation of related factors of remained dysplasia after treatment of cervical intraepithelial neoplasia by cold knife conization (longitudinal study)

Document Type : Original Article

Authors

1 Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associated Professor, Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor, Department of Biostatistics and Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Professor, Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction Basic treatment of patients with cervical intraepithelial neoplasia is prevention of regress to invasive carcinoma. One of the treatment methods of these patients is conization. This study was performed with the aim to evaluate the related factors of remained dysplasia after treatment of cervical intraepithelial neoplasia (CIN) by cold knife conization.
Methods: This Cohort study was performed on 25 patients with cervical dysplasia who were diagnosed in colposcopy and underwent cold knife conization with indication of conization in 2013. Based on the results of conization, hysterectomy was performed for the patients with high grade dysplasia, in-situ intraepithelial cancer, microscopic invasive cancer and positive margin specimens. Histology results of these patients were compared to pathologic result of the patients with dysplasia and negative margin conization who underwent conization for other reasons. Finally, the factors of remained dysplasia after treatment of CIN with cold knife conization were evaluated. Data was analyzed using statistical SPSS software (version 17) and T-test and Mann-Whitney test.  P≤ 0.05 was considered significant.       
Results: Among 25 patients, only one case of conization specimen margin was positive for dysplasia that was appeared to be invasive Squamous cell carcinoma in performed hysterectomy. Other 11 patients who despite negative margin underwent hysterectomy, 4 patients (36.3%) have high grade dysplasia (CIN  III), 1 patient (9%) have low grade dysplasia (CIN I) and 6 patients (54.5%) were free of remained dysplasia in cervical pathology bioopsy after conization. The results showed that severity of cervical dysplasia with remained disease after conization is the factor of remained dysplasia after treatment of CIN.
Conclusion: Severity of dysplasia is an effective prognostic factor patients in the possibility of remained dysplasia after conization in patients with cervical dysplasia, thus, close follow-up of these patients is recommended.

Keywords

References

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