Risk Factor Analysis of Persistent High-Grade Squamous Intraepithelial Lesion After Loop Electrosurgical Excision...

Area of Science:

• Gynecology
• Oncology
• Pathology

Background:

• Cervical cancer screening relies on detecting high-grade squamous intraepithelial lesions (HSIL).
• Loop electrosurgical excision procedure (LEEP) is a common treatment for HSIL.
• Understanding outcomes and risk factors for persistent HSIL post-LEEP is critical for patient management.

Purpose of the Study:

• To analyze clinical outcomes of HSIL 6 months after LEEP.
• To identify risk factors for persistent HSIL following LEEP.
• To evaluate follow-up methods for persistent HSIL post-LEEP.

Main Methods:

• Retrospective study of 3582 women with HSIL undergoing LEEP (2011-2015).
• Assessment of risk factors for persistent HSIL at 6-month follow-up.
• Follow-up included cervical cytology, high-risk HPV (hrHPV) testing, colposcopy, and endocervical curettage.

Main Results:

• 101 women (2.8%) had persistent HSIL; 9 cases of invasive cervical cancer were found.
• Persistence rate was higher in women aged 50 years or older.
• Positive LEEP margins, especially endocervical, and positive hrHPV/abnormal cytology during follow-up were independent risk factors for persistent HSIL.

Conclusions:

• Older age (≥50 years), positive margins (particularly endocervical), and abnormal follow-up cytology or hrHPV testing are risk factors for persistent HSIL post-LEEP.
• Colposcopy is essential for diagnosing persistent HSIL and monitoring disease progression.