Diagnosis, treatment and follow-up of H.P.V.-C.I.N

Between April 1989 and December 1993, eight thousand one hundred women under cytologic suspect of human papillomavirus (HPV) cervical infection underwent new cytology, colposcopy, colposcopically directed exocervical biopsy, and, eventually, endocervical curettage. HPV cervical lesions were confirmed in 300 patients (3.7%), on the basis of at least, two positive diagnostic methods. Prior to surgery, the Papanicolaou smear was negative in 50 women, cervical intraepithelial neoplasia (CIN) I in 170 cases, CIN II in 70, and CIN III in the other 10 patients. Cryosurgery was practised in CIN I, II, or III and clinical condylomata (a total of 200 patients: 66.6%). Following cryosurgery, patients were seen six weeks and one year after for repeating cytology, colposcopy and cervical biopsy (if necessary). One-year-later cytology was negative in 230 cases (76.7%); 60 (20%) of CIN I; 7 (2.3%) of CIN II; and only one case of CIN III. At the same moment, colposcopy was normal in 66.6% of these patients. The incidence of cervical HPV (3.7%) is higher than the one referred by other authors, because of the use of endocervical curettage. We conclude the cryosurgery is quite a good therapeutic method in HPV cervical lesions.