| Cervical intraepithelial neoplasia treatment in Human Immunodeficiency Virus-positive women. | |
| | |
MedLine Citation:
|
PMID: 18569480 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
We set out to consider the level of agreement between referral and treatment pathology and to investigate the effectiveness of standard surgical treatment for cervical intraepithelial neoplasia (CIN) in Human Immunodeficiency Virus (HIV)-positive women. This was a case-note review of all women who underwent treatment for CIN between 1995 and 2004. Information on the referral and follow-up smear and biopsy results and the status of the excision margins at treatment were collected. A total of 71 women had at least one large loop excision of the transformation zone (LLETZ) for CIN. Agreement between the referral smear and biopsy was poor (kappa = 0.20) and between the referral and treatment pathology was only fair (kappa = 0.37). Ten treatment samples showed no histological evidence of CIN and were excluded from analysis of the presence of CIN at the resection margins. In only 32.8% of treatment samples were both margins clear of CIN. A high pre-LLETZ CD4 count was strongly associated with clear margins. A total of 55.6% patients had CIN at follow-up, despite both margins being clear. The follow-up smear/biopsy had decreased by >or=1 grade of CIN in only 50.8% patients. Our results show a high degree of discrepancy between cytology/biopsy and LLETZ histology in HIV-positive women. Additionally, there is often incomplete clearance of CIN at the resection margins emphasing the need for close follow-up after surgery. |
| | |
Authors:
|
S Shah; H Montgomery; J C Crow; C J Smith; A Moore; C A Sabin; H Evans; M A Johnson |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology Volume: 28 ISSN: 1364-6893 ISO Abbreviation: J Obstet Gynaecol Publication Date: 2008 Apr |
Date Detail:
|
Created Date: 2008-06-23 Completed Date: 2008-08-28 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8309140 Medline TA: J Obstet Gynaecol Country: England |
Other Details:
|
Languages: eng Pagination: 327-32 Citation Subset: IM |
Affiliation:
|
Department of Primary Care, Royal Free and University College Medical Schools, London, UK. s.shah@pcps.ucl.ac.uk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Antiretroviral Therapy, Highly Active / methods Biopsy, Needle Cervical Intraepithelial Neoplasia / epidemiology*, pathology, surgery* Cohort Studies Colposcopy / methods* Comorbidity Conization / methods Female Great Britain / epidemiology HIV Infections / diagnosis, drug therapy, epidemiology* HIV Seropositivity Humans Immunohistochemistry Mass Screening / methods Middle Aged Neoplasm Staging Probability Prognosis Referral and Consultation / statistics & numerical data Retrospective Studies Risk Assessment Survival Analysis Treatment Outcome Uterine Cervical Neoplasms / epidemiology*, pathology, surgery* Vaginal Smears |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Sociocultural impediments to male factor infertility evaluation in rural South-east Nigeria.
Next Document: Poverty eradication and decreased human papilloma virus related cancer of the penis and vulva in Jam...