Does CIN2 Have the Same Aggressive Potential As CIN3? A Secondary Analysis of High-Grade Cytology Recurrence in Women Treated with Cold-Coagulation Cervical Treatment

Papoutsis, D.; Underwood, M.; Parry-Smith, W.; Panikkar, J.

Abstract

Introduction To determine whether women with CIN2 versus CIN3 on pretreatment cervical punch biopsy have less high-grade cytology recurrence following cold-coagulation cervical treatment.

Materials and Methods This was a retrospective study of women having had cold coagulation between 2001–2011 in our colposcopy unit. Women with previous cervical treatment were excluded.

Results We identified 402 women with 260 (64.7 %) cases of CIN2 and 142 (35.3 %) cases of CIN3 on pretreatment cervical punch biopsy. In the total sample, the mean age of women was 27.5 years (SD = 4.9), 75.1 % were nulliparous and 36.6 % were smokers. Referral cytology and pretreatment colposcopic appearance were high-grade in 62.7 % and 57.1 %. The mean follow-up period was 2.8 years (SD = 2.1). Women with CIN2 on pretreatment cervical biopsy when compared to those with CIN3 had less frequently high-grade referral cytology and high-grade pretreatment colposcopic appearances, and had less pretreatment cervical biopsies taken. During the follow-up period, women with CIN2 on pretreatment cervical biopsy had less high-grade cytology recurrence when compared to those women with CIN3 (1.9 vs. 5.6 %, p = 0.046). Multiple stepwise Cox regression analysis showed that women with CIN3 on pretreatment cervical biopsy had 3.21 times greater hazard for high-grade cytology recurrence (HR = 3.21, 95 % CI: 1.05–9.89; p = 0.041) in comparison with CIN2 cases.

Conclusion We found that women with CIN2 on pretreatment cervical punch biopsy had less high-grade cytology recurrence following cold-coagulation treatment in comparison to those with CIN3. This finding lends support to the theory that CIN2 even though a high-grade abnormality might not have the same aggressive potential as CIN3.

Citation

Papoutsis, D., Underwood, M., Parry-Smith, W., & Panikkar, J. (2017). Does CIN2 Have the Same Aggressive Potential As CIN3? A Secondary Analysis of High-Grade Cytology Recurrence in Women Treated with Cold-Coagulation Cervical Treatment. Geburtshilfe und Frauenheilkunde, 77(03), 284-289. https://doi.org/10.1055/s-0042-119993

• Journal Article Type: Article
• Acceptance Date: Oct 24, 2016
• Online Publication Date: Apr 6, 2017
• Publication Date: 2017
• Deposit Date: Jan 23, 2024
• Journal: Geburtshilfe und Frauenheilkunde
• Print ISSN: 0016-5751
• Electronic ISSN: 1438-8804
• Publisher: Thieme Gruppe
• Peer Reviewed: Peer Reviewed
• Volume: 77
• Issue: 03
• Pages: 284-289
• DOI: https://doi.org/10.1055/s-0042-119993
• Keywords: Maternity and Midwifery; Obstetrics and Gynecology