Loop electrosurgical excision procedure combined with cold coagulation for cervical intraepithelial neoplasia and adenocarcinoma in-situ: a feasible treatment with a low risk of residual/recurrent disease

Infectious Agents and Cancer

Nae Ry Kim¹  Eun Jung Yang¹  Ji Yeon Choi¹  Sun Joo Lee¹  Wook Youn Kim² 

[1] Department of Obstetrics and Gynecology, Konkuk University Hospital, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, 05030, Seoul, Korea;Department of Pathology, KonKuk University Hospital, Seoul, Republic of Korea;

关键词: Cervical intraepithelial neoplasia;    Microinvasive carcinoma;    Loop electrosurgical excision procedure;    Cold coagulation;    Resection margin;   

DOI  :  10.1186/s13027-020-00326-3

来源: Springer

【 摘 要 】

ObjectiveThis study was performed to evaluate the significance of positive resection margins (RMs) with the loop electrosurgical excision procedure combined with cold coagulation (LEEP with CC) as a definitive treatment for patients with cervical intraepithelial neoplasia (CIN) and adenocarcinoma in-situ.MethodsWe retrospectively reviewed 467 patients who underwent LEEP with CC. A right-angled triangular loop in a single pass followed by a CC (120 °C) to the cone bed for 10 to 20 s was used. Pathology reports and clinical data were obtained and evaluated.ResultsHistopathology evaluation of LEEP tissue samples revealed the presence of CIN 1 in 69, CIN 2/3 in 366, AIS in 5 and invasive carcinoma in 16 (microinvasive squamous cell carcinoma (SCC) and invasive SCC, 13 and 3) patients. Margins were positive in 66 (14.5%) cases: 0 in CIN 1, 54 in CIN 2/3 (12.4%), 1 in AIS (20.0%) and 11 in microinvasive/invasive SCC (68.8%). Although 54 CIN2/3 patients with positive RMs did not undergo additional treatment, 1 of these (1.9%) was confirmed to have residual CIN3 at the first follow-up. Two of 8 (25.0%) microinvasive SCC patients with positive RMs were confirmed to have residual diseases (1 microinvasive SCC and 1 invasive SCC) after hysterectomy. Four out of 360 (1 positive RM, 3 negative RM) CIN cases recurred during the study period.ConclusionsThese results suggest that CIN patients with positive RMs after LEEP with CC may be followed up without additional treatment.

【 授权许可】

CC BY