International Journal of Clinical Oncology

, Volume 17, Issue 3, pp 233–239

Subsequent risks for cervical precancer and cancer in women with low-grade squamous intraepithelial lesions unconfirmed by colposcopy-directed biopsy: results from a multicenter, prospective, cohort study

  • Koji Matsumoto
  • Yasuo Hirai
  • Reiko Furuta
  • Naoyoshi Takatsuka
  • Akinori Oki
  • Toshiharu Yasugi
  • Hiroo Maeda
  • Akira Mitsuhashi
  • Takuma Fujii
  • Kei Kawana
  • Tsuyoshi Iwasaka
  • Nobuo Yaegashi
  • Yoh Watanabe
  • Yutaka Nagai
  • Tomoyuki Kitagawa
  • Hiroyuki Yoshikawa
  • For Japan HPV and Cervical Cancer (JHACC) Study Group
Original Article

DOI: 10.1007/s10147-011-0280-9

Cite this article as:
Matsumoto, K., Hirai, Y., Furuta, R. et al. Int J Clin Oncol (2012) 17: 233. doi:10.1007/s10147-011-0280-9

Abstract

Objective

To investigate the natural course of low-grade squamous intraepithelial lesions (LSILs) that cannot be histologically confirmed by colposcopy-directed biopsy.

Methods

In a multicenter, prospective, cohort study of Japanese women with LSILs, we analyzed the follow-up data from 64 women who had a negative biopsy result at the initial colposcopy (biopsy-negative LSIL) in comparison with those from 479 women who had a histologic diagnosis of cervical intraepithelial neoplasia grade 1 (LSIL/CIN1). Patients were monitored by cytology and colposcopy every 4 months for a mean follow-up period of 39.0 months, with cytologic regression defined as two consecutive negative smears and normal colposcopy.

Results

In women with biopsy-negative LSILs, there were no cases of CIN3 or worse (CIN3+) diagnosed within 2 years; the difference in the 2-year risk of CIN3+ between the two groups was marginally significant (0 vs. 5.5%; P = 0.07). The cumulative probability of cytologic regression within 12 months was much higher in the biopsy-negative LSIL group (71.2 vs. 48.6%; P = 0.0001). The percentage of women positive for high-risk human papillomaviruses (hrHPVs) was significantly lower in the biopsy-negative LSIL group than in the LSIL/CIN1 group (62.1 vs. 78.4%; P = 0.01); however, the 12-month regression rate of biopsy-negative LSIL was similar between hrHPV-positive and -negative women (67.3 vs. 74.4%, P = 0.73).

Conclusion

In women with biopsy-negative LSILs, the risk of CIN3+ diagnosed within 2 years was low; furthermore, approximately 70% underwent cytologic regression within 12 months, regardless of HPV testing results. Biopsy-negative LSILs may represent regressing lesions rather than lesions missed by colposcopy.

Keywords

Low-grade squamous intraepithelial lesion Colposcopy Human papillomavirus Cervical intraepithelial neoplasia 

Copyright information

© Japan Society of Clinical Oncology 2011

Authors and Affiliations

  • Koji Matsumoto
    • 1
  • Yasuo Hirai
    • 2
  • Reiko Furuta
    • 3
  • Naoyoshi Takatsuka
    • 4
  • Akinori Oki
    • 1
  • Toshiharu Yasugi
    • 5
  • Hiroo Maeda
    • 6
  • Akira Mitsuhashi
    • 7
  • Takuma Fujii
    • 8
  • Kei Kawana
    • 5
  • Tsuyoshi Iwasaka
    • 9
  • Nobuo Yaegashi
    • 10
  • Yoh Watanabe
    • 11
  • Yutaka Nagai
    • 12
  • Tomoyuki Kitagawa
    • 3
  • Hiroyuki Yoshikawa
    • 1
  • For Japan HPV and Cervical Cancer (JHACC) Study Group
  1. 1.Department of Obstetrics and Gynecology, Graduate School of Comprehensive Human ScienceUniversity of TsukubaTsukubaJapan
  2. 2.Departments of Gynecology and CytopathologyCancer Institute Hospital, Japanese Foundation of Cancer ResearchTokyoJapan
  3. 3.Department of PathologyCancer Institute, Japanese Foundation of Cancer ResearchTokyoJapan
  4. 4.Department of Epidemiology and Preventive MedicineGifu University Graduate School of MedicineGifuJapan
  5. 5.Department of Obstetrics and GynecologyUniversity of TokyoTokyoJapan
  6. 6.Department of Transfusion Medicine and Cell Therapy, Saitama Medical CenterSaitama Medical UniversitySaitamaJapan
  7. 7.Department of Reproductive Medicine, Graduate School of MedicineChiba UniversityChibaJapan
  8. 8.Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan
  9. 9.Department of Obstetrics and GynecologyFaculty of Medicine, Saga UniversitySagaJapan
  10. 10.Department of Obstetrics and GynecologyTohoku University School of MedicineSendaiJapan
  11. 11.Department of Obstetrics and GynecologyKinki University School of MedicineOsakaJapan
  12. 12.Department of Obstetrics and Gynecology, Faculty of MedicineUniversity of the RyukyusOkinawaJapan

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