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Abnormal cervical cytology following large loop excision of the transformation zone : a case controlled study

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Shafi, M. I., Dunn, Janet A., Buxton, E. J., Finn, C. B., Jordan, J. A. and Luesley, D. M. (1993) Abnormal cervical cytology following large loop excision of the transformation zone : a case controlled study. Obstetrical and Gynecological Survey, 48 (8). pp. 546-548. doi:10.1111/j.1471-0528.1993.tb15210.x

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Official URL: https://doi.org/10.1111/j.1471-0528.1993.tb15210.x

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Abstract

Objectives To determine factors that may predict cytological outcome at 6 months following large loop excision of transformation zone (LLETZ) for cervical intra epithelial neoplasia (CIN) and to investigate the outcome in women with continuing cytological abnormality.

Design Case controlled retrospective study.

Setting Dudley Road Hospital, Birmingham and Midland Hospital for Women.

Subjects Fifty‐eight women with abnormal follow up cytology and a control group of 116 women.

Main outcome measures The relation between pretreatment and treatment factors and cytological outcome, and the relation between cytology and histology in women who had biopsies for persistent adnormal cytology.

Results Univariate and stepwise logistic regression analysis showed that the number of sectors of atypical transformation zone (lesion size) and the excision margin status of the large loop excision specimen are of prognostic importance for the prediction of cytological abnormality at the 6 month follow up visit. Sixteen women have undergone further cervical biopsy. Of the five cases of persistent CIN, four had cytological changes showing moderate or severe dyskaryosis. Of the 11 women with koilocytosis or normal histology, 10 had mild dyskaryosis or borderline changes on their follow up cytology.

Conclusion Lesion size and excision margin status are important correlates of follow up cytology when treating patients for CIN with LLETZ. All women with abnormal cervical cytology at follow up should undergo colposcopic assessment. Excision biopsy is indicated if follow up cytology shows moderate or severe dyskaryosis, especially if still present 12 months after treatment.

Item Type: Journal Article
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Journal or Publication Title: Obstetrical and Gynecological Survey
Publisher: Wolters Kluwer
ISSN: 0029-7828
Official Date: February 1993
Dates:
DateEvent
February 1993Published
27 September 1992Accepted
Volume: 48
Number: 8
Page Range: pp. 546-548
DOI: 10.1111/j.1471-0528.1993.tb15210.x
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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