دورية أكاديمية
Colposcopically Directed Biopsy Before Ablative Treatment Versus Direct Ablative Treatment in Patients With Cervical Oncogenic HPV.
| العنوان: | Colposcopically Directed Biopsy Before Ablative Treatment Versus Direct Ablative Treatment in Patients With Cervical Oncogenic HPV. |
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| المؤلفون: | Erasun D; Hospital Universitario Valdecilla, Santander, Spain., Delcampo AV; Hospital Universitario Valdecilla, Santander, Spain., DE Castro A; Hospital Universitario Valdecilla, Santander, Spain., Munoz-Solano A; Hospital Universitario Valdecilla, Santander, Spain., Schneider J; Universidad de Valladolid, Departamento de Ginecología, Valladolid, Spain. |
| المصدر: | Cancer diagnosis & prognosis [Cancer Diagn Progn] 2024 Jul 03; Vol. 4 (4), pp. 430-433. Date of Electronic Publication: 2024 Jul 03 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: International Institute of Anticancer Research Country of Publication: Greece NLM ID: 9918316186306676 Publication Model: eCollection Cited Medium: Internet ISSN: 2732-7787 (Electronic) Linking ISSN: 27327787 NLM ISO Abbreviation: Cancer Diagn Progn Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Kapandriti : International Institute of Anticancer Research, [2021]- |
| مستخلص: | Background/aim: In the past, the standard of care for women with abnormal cervical cytology has been the performance of colposcopically guided biopsy, followed by conization or large loop excision of the transition zone (LLETZ) where biopsy revealed pre-cancerous or cancerous areas. More straightforward protocols are emerging which advocate performing LLETZ in all women with highly suspicious cytology, suspicious colposcopic impression, or the presence of high-risk oncogenic human papilloma virus (HPV) strains in their cervical swabs. This, theoretically, would reduce the rate of false-negative diagnoses, but at the price of overtreating a significant number of healthy women. Patients and Methods: We retrospectively analyzed cervical cancer screening protocols in two large cohorts of women with high-risk HPV. The study compared outcomes between patients undergoing a colposcopically directed biopsy before LLETZ (n=683) and those proceeding directly to LLETZ without a biopsy (n=136). The primary focus was to assess whether intervening biopsies would reduce unnecessary ablative procedures without compromising the detection of high-grade lesions. Results: The biopsy group had a high false-negative rate, with several high-grade lesions (CIN3) and a case of invasive cancer initially underdiagnosed. Conversely, the direct-to-LLETZ approach, while ensuring no high-grade lesions were missed, led to overtreatment of lower grade lesions. Conclusion: These findings raise concern about the reliance on biopsy results for treatment decisions. Neither protocol was entirely satisfactory, although the more aggressive one avoided the potentially life-threatening consequence of false-negative results. Further research is mandatory to accurately diagnose all cases requiring aggressive treatment, without subjecting healthy women to ablative treatments they do not need. Competing Interests: None. (Copyright 2024, International Institute of Anticancer Research.) |
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| فهرسة مساهمة: | Keywords: Cervix; HPV; LLETZ; biopsy; colposcopy |
| تواريخ الأحداث: | Date Created: 20240704 Latest Revision: 20240705 |
| رمز التحديث: | 20240705 |
| مُعرف محوري في PubMed: | PMC11215457 |
| DOI: | 10.21873/cdp.10343 |
| PMID: | 38962553 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2732-7787 |
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| DOI: | 10.21873/cdp.10343 |