Risk Factors for Persistence or Recurrence of High-Grade Cervical Squamous Intraepithelial Lesions
ABSTRACT Objectives: to evaluate whether the colposcopic lesion size , age, kind of surgery, the status of the surgical margins and the expression of the p16 and Ki-67 immunomarkers are risk factors for persistence or recurrence of the lesion. Methods: a cross-sectional, observational, retrospecti...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgiões
2023-12-01
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| Series: | Revista do Colégio Brasileiro de Cirurgiões |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912023000100241&lng=en&tlng=en |
| _version_ | 1797404390394429440 |
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| author | Dulcimary Dias Bittencourt Rita Maira Zanine Ana Paula Martins Sebastião Carmen Marcondes Ribas |
| author_facet | Dulcimary Dias Bittencourt Rita Maira Zanine Ana Paula Martins Sebastião Carmen Marcondes Ribas |
| author_sort | Dulcimary Dias Bittencourt |
| collection | DOAJ |
| description | ABSTRACT Objectives: to evaluate whether the colposcopic lesion size , age, kind of surgery, the status of the surgical margins and the expression of the p16 and Ki-67 immunomarkers are risk factors for persistence or recurrence of the lesion. Methods: a cross-sectional, observational, retrospective study of patients submitted to cold knife conization (CKC) or the loop electrosurgical excision procedure for cervical intraepithelial neoplasia 2 or 3. The colposcopic lesion size, age, surgical method, involvement of the surgical margins, and p16/Ki-67 immunomarker expression were analyzed in relation to lesion persistence and recurrence. Results: seventy-one women were treated with cold knife conization and 200 were treated with loop electrosurgical excision. Of these, 95 had cervical intraepithelial neoplasia 2, 173 had cervical intraepithelial neoplasia 3, 183 had free surgical margins, 76 had compromised margins, and 12 showed damage by processing artifact or fragments. Among the 76 cases with positive margins, 55, 11, and 10 showed endocervical margin involvement, ectocervical margin involvement, and both endocervial and ectocervical margin involvement, respectively. Of the 264 followed-up patients, 38 had persistent or recurrent disease. A multiple logistic regression indicated that positive endocervical margins are the only independent risk factor for the persistence/recurrence of cervical intraepithelial neoplasia. No significant association was identified between the colposcopic lesion size, age, surgery type, or p16/Ki-67 immunomarker expression and lesion persistence or recurrence. |
| first_indexed | 2024-03-09T02:54:16Z |
| format | Article |
| id | doaj.art-9314583d07ff4e42a8f66ce14cdc6917 |
| institution | Directory Open Access Journal |
| issn | 1809-4546 |
| language | English |
| last_indexed | 2024-03-09T02:54:16Z |
| publishDate | 2023-12-01 |
| publisher | Colégio Brasileiro de Cirurgiões |
| record_format | Article |
| series | Revista do Colégio Brasileiro de Cirurgiões |
| spelling | doaj.art-9314583d07ff4e42a8f66ce14cdc69172023-12-05T07:50:44ZengColégio Brasileiro de CirurgiõesRevista do Colégio Brasileiro de Cirurgiões1809-45462023-12-015010.1590/0100-6991e-20233537-enRisk Factors for Persistence or Recurrence of High-Grade Cervical Squamous Intraepithelial LesionsDulcimary Dias Bittencourthttps://orcid.org/0000-0002-4627-5398Rita Maira Zaninehttps://orcid.org/0000-0001-9210-2925Ana Paula Martins Sebastiãohttps://orcid.org/0000-0002-3908-821XCarmen Marcondes Ribashttps://orcid.org/0000-0002-6195-046XABSTRACT Objectives: to evaluate whether the colposcopic lesion size , age, kind of surgery, the status of the surgical margins and the expression of the p16 and Ki-67 immunomarkers are risk factors for persistence or recurrence of the lesion. Methods: a cross-sectional, observational, retrospective study of patients submitted to cold knife conization (CKC) or the loop electrosurgical excision procedure for cervical intraepithelial neoplasia 2 or 3. The colposcopic lesion size, age, surgical method, involvement of the surgical margins, and p16/Ki-67 immunomarker expression were analyzed in relation to lesion persistence and recurrence. Results: seventy-one women were treated with cold knife conization and 200 were treated with loop electrosurgical excision. Of these, 95 had cervical intraepithelial neoplasia 2, 173 had cervical intraepithelial neoplasia 3, 183 had free surgical margins, 76 had compromised margins, and 12 showed damage by processing artifact or fragments. Among the 76 cases with positive margins, 55, 11, and 10 showed endocervical margin involvement, ectocervical margin involvement, and both endocervial and ectocervical margin involvement, respectively. Of the 264 followed-up patients, 38 had persistent or recurrent disease. A multiple logistic regression indicated that positive endocervical margins are the only independent risk factor for the persistence/recurrence of cervical intraepithelial neoplasia. No significant association was identified between the colposcopic lesion size, age, surgery type, or p16/Ki-67 immunomarker expression and lesion persistence or recurrence.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912023000100241&lng=en&tlng=enBiomarkersCervixNeoplasmsRecurrenceSurgical Procedures |
| spellingShingle | Dulcimary Dias Bittencourt Rita Maira Zanine Ana Paula Martins Sebastião Carmen Marcondes Ribas Risk Factors for Persistence or Recurrence of High-Grade Cervical Squamous Intraepithelial Lesions Revista do Colégio Brasileiro de Cirurgiões Biomarkers Cervix Neoplasms Recurrence Surgical Procedures |
| title | Risk Factors for Persistence or Recurrence of High-Grade Cervical Squamous Intraepithelial Lesions |
| title_full | Risk Factors for Persistence or Recurrence of High-Grade Cervical Squamous Intraepithelial Lesions |
| title_fullStr | Risk Factors for Persistence or Recurrence of High-Grade Cervical Squamous Intraepithelial Lesions |
| title_full_unstemmed | Risk Factors for Persistence or Recurrence of High-Grade Cervical Squamous Intraepithelial Lesions |
| title_short | Risk Factors for Persistence or Recurrence of High-Grade Cervical Squamous Intraepithelial Lesions |
| title_sort | risk factors for persistence or recurrence of high grade cervical squamous intraepithelial lesions |
| topic | Biomarkers Cervix Neoplasms Recurrence Surgical Procedures |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912023000100241&lng=en&tlng=en |
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