Summary
We report results of follow-up by PAP smears and colposcopy in 116 women treated since 1981 by conization for cervical intraepithelial neoplasia with human papillomavirus infection (HPV-CIN). The mean follow-up time was 31.9 (SD 19) months. Preoperative diagnosis was HPV-CIN II (with extension into the endocervix) in 11 cases and HPV-CIN III in 103 cases; two diagnostic conizations were performed. The histological examination of the cone biopsies showed complete excision of CIN in 109 cases (94%). Three patients underwent hysterectomy after conization; one had microinvasion in the cone biopsy, one had suspicion of microinvasion and one had non-radical conization. Three patients (2.6%) were lost to follow-up. After excluding these six patients the primary cure rate of HPV lesions (normal cytological and colposcopical finding after conization) was 82.7%. Four patients (4.6%) had residual CIN after conization. During the follow-up 15 patients had recurrence of HPV infection, only one had HPV-CIN I. HPV 16 was the most common HPV type (56/116, 48.2%) in the conization group and also in the recurrent cases (9/15, 60%). The results support the role of HPV 16 in cervical carcinogenesis.
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References
Ahlgren M, Ingemarsson I, Lindberg LG, Nordqvist SRB (1975) Conization as treatment of carcinoma in situ of the uterine cervix. Obstet Gynecol 46:135–140
Baggish MS (1986) A comparison between laser excisional conization and laser vaporization for the treatment of cervical intraepithelial neoplasia. Am J Obstet Gynecol 155:39–44
Baggish MS, Dorsey JH, Adelson M (1989) A ten-year experience treating cervical intraepithelial neoplasia with CO2 laser. Am J Obstet Gynecol 161:60–68
Bostofte E, Berget A, Larsen JF, Pedersen PH, Rank F (1986) Conization by carbon dioxide laser or cold knife in the treatment of cervical intraepithelial neoplasia. Acta Obstet Gynecol Scand 65:199–202
Bryson SCP, Lenehan P, Lickrish GM (1985) The treatment of grade 3 cervical intraepithelial neoplasia with cryotherapy: an 11-year experience. Am J Obstet Gynecol 151:201–206
Burghardt E, Holzer E (1980) Treatment of carcinoma in situ: evaluation of 1609 cases. Obstet Gynecol 55:539–545
Buxton EJ, Luesley DM, Wade-Evans T, Jordan JA (1987) Residual disease after cone biopsy: completeness of excision and follow-up cytology as predictive factors. Obstet Gynecol 70:529–532
Chanen W (1984) Symposium on cervical neoplasia III. Electrocoagulation diathermy. Colposcopy Gynecol Laser Surg 1:281–284
Creasman WT, Weed JC, Curry SL, Johnston WW, Parker RT (1972) Efficacy of cryosurgical treatment of severe cervical intraepithelial neoplasia. Obstet Gynecol 41:501–506
Göppinger A, Ikenberg H, Birmelin G, Hilgarth M, Pfleiderer A, Hillemanns HG (1988) CO2-Lasertherapie und HPV-Typisierung bei CIN-Verlaufsbeobachtungen. Geburtsh Frauenheilkd 48:343–345
Helmerhorst TJM, Dijkuizen GH, Calame JJ, Kwikkel HJ, Stolk JG (1987) The accuracy of colposcopically directed biopsy in diagnosis of CIN. Eur J Obstet Gynecol Reprod Biol 24:221–229
Kataja V, Syrjänen K, Mäntyjärvi R, Vayrynen M, Syrjänen S, Saarikoski S, Parkkinen S, Yliskoski M, Salonen JT, Castren O (1989) Prospective follow-up of cervical HPV infections: life-table analysis of histopathological, cytological and colposcopic data. Eur J Epidemiol 5:1–7
Kataja V, Syrjänen K, Syrjänen S, Mäntyjärvi R, Yliskoskí M, Saarikoski S, Salonen JT (1990) Prospective follow-up of genital HPV infections: survival analysis of the HPV typing data. Eur J Epidemiol 6:9–14
Kolstad P, Klem V (1976) Long-term follow-up of 1121 cases of carcinoma in situ. Obstet Gynecol 48:125–129
Larsson G (1983) Conization for preinvasive and early invasive carcinoma of the uterine cervix. Acta Obstet Gynecol [Suppl] 114:1–40
McIndoe GA, Robson MS, Tidy JA, Mason WP, Anderson MC (1989) Laser excision rather than vaporization: the treatment of choice for cervical intraepithelial neoplasia. Obstet Gynecol 74:165–168
Mohajer MP, Hitchcock A, Liu DTY, Cotton RE (1989) Exfoliative cytology as a means of following incomplete cone biopsies: a pilot study. J Obstet Gynecol 10:149–152
Pearson SE, Whittaker J, Ireland D, Monaghan JM (1989) Invasive cancer of the cervix after laser treatment. Br J Obstet Gynaecol 96:486–488
Sadoul GD, Beuret TM (1986) Management of 633 cervical intraepithelial neoplasias by CO2 laser: persistent diseases and recurrences. Laser Surg Med 6:110–118
Stein DS, Ulrich SA, Hasiuk AS (1985) Laser vaporization in the treatment of cervical intraepithelial neoplasia. J Reprod Med 30:179–183
Syrjänen K, Mäntyjärvi R, Saarikoski S, Väyrynen M, Syrjänen S, Parkkinen S, Yliskoski M, Saastamoinen J, Castren O (1988) Factors associated which progression of human papillomavirus (HPV) infections into carcinoma in situ during long-term prospective follow-up. Br J Obstet Gynaecol 95:1096–1102
Syrjänen S, Partanen P, Mäntyjärvi R, Syrjänen K (1988) Sensitivity of in situ hybridization techniques using biotin- and35S-labeled human papillomavirus (HPV) DNA probes. J Virol Meth 19:225–238
Yliskoski M, Saarikoski S, Syrjänen K, Syrjänen S, Castren O (1989) Cryotherapy and CO2 laser vaporization in the treatment of cervical and vaginal human papillomavirus (HPV) infections. Acta Obstet Gynecol Scand 68:619–625
Yliskoski M, Cantell K, Syrjänen K, Syrjänen S (1990) Topical treatment with human leukocyte interferon of HPV 16 infections associated with cervical and vaginal intraepithelial neoplasias. Gynecol Oncol 36:353–357
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Yliskoski, M., Saarikoski, S. & Syrjänen, K. Conization for CIN associated with human papillomavirus infection. Arch Gynecol Obstet 249, 59–65 (1991). https://doi.org/10.1007/BF02390363
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DOI: https://doi.org/10.1007/BF02390363