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Frequency of cervical intraepithelial neoplasia grade II or worse in women with a persistent low-grade squamous intraepithelial lesion seen by Papanicolaou smears

Archives of Gynecology and Obstetrics volume 288, pages 1125–1130 (2013)Cite this article

Abstract

Purpose

We investigated the frequency of cervical intraepithelial neoplasia (CIN) grade II or worse in low-income Brazilian women with persistent low-grade squamous intraepithelial lesions (LSIL).

Methods

A retrospective review of medical records was performed for all patients who underwent a loop electrosurgical excision procedure (LEEP) with "see and treat" strategy for persistent LSIL seen on Papanicolaou (Pap) smears (persisting >12 months in at least two consecutive tests, over a 50-month period. We assessed the colposcopy and histopathology results at the time of the procedure and at follow-up, using Pap and histopathology.

Results

Of 106 women, 48 (45.3 %) had no dysplasia by histopathology, 18 (17.0 %) had CIN I, 29 (27.4 %) had CIN II and 10 (9.4 %) had CIN III. Among the patients with CIN, 38 (66.7 %) performed the follow-up. Of these, only 4 (10.5 %) were classified as follow-up (+), all had CIN I. Women with initial CIN I had 16.7 % (n = 2) recurrences; those with initial CIN II had 5.9 % (n = 1); and those with initial CIN III had 11.1 % (n = 1) (p > 0.05).

Conclusions

A very high proportion of the women with persistent LSIL had CIN II/III on post-LEEP histopathology. Recurrence rates were equal to than those that originally caused the patients to be subjected to LEEP (LSIL). The benefits of the "see and treat" protocol by LEEP for persistent LSIL outweigh the risk of overtreatment, principally in low-resource settings where poor patient compliance is expected, as in Brazil.

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Acknowledgments

This work was supported by Grants from Fundação Araucária de Apoio ao Desenvolvimento Cientifico e Tecnológico do Paraná e Ministério da Saúde from Brazil, project EFP 00002873-SISCT.

Conflict interest

None.

Author information

Affiliations

  1. Clinical Cytology Laboratory, Department of Clinical Analysis and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil

    P. R. B. Nogara & M. E. L. Consolaro

  2. Division of Gynecology, Sixth Region of Public Health of Paraná (CISVALI) Hospital, União da Vitória, Paraná, Brazil

    L. A. R. Manfroni

  3. Departamento de Análises Clínicas e Biomedicina—DAB, Universidade Estadual de Maringá, Av: Colombo, 5790, Maringá, Paraná, 87020-900, Brazil

    M. E. L. Consolaro

Authors
  1. P. R. B. Nogara
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  2. L. A. R. Manfroni
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  3. M. E. L. Consolaro
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Correspondence to M. E. L. Consolaro.

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Nogara, P.R.B., Manfroni, L.A.R. & Consolaro, M.E.L. Frequency of cervical intraepithelial neoplasia grade II or worse in women with a persistent low-grade squamous intraepithelial lesion seen by Papanicolaou smears. Arch Gynecol Obstet 288, 1125–1130 (2013). https://doi.org/10.1007/s00404-013-2872-2

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  • DOI: https://doi.org/10.1007/s00404-013-2872-2

Keywords

  • LSIL
  • Persistent
  • Cytology
  • CIN II/III
  • Cervical cancer prevention