Analysis of follow-up interval after conization

Abstract

Cervical neoplasia (CIN) is a non-invasive neoplastic lesion widely regarded as a precursor of squamous cell carcinoma (SCC) of the cervix. The highest incidence of CIN is seen during women’s reproductive years. Conization is required either to diagnose or to remove pre-cancerous cells. Furthermore, follow-up after treatment to identify residual and recurrent lesions is usually recommended. However, the follow-up interval after treatment has not been well-established. We analyzed the follow-up interval based on cervical cytology three and six months after conization. From april 2010 to september 2011, 94 women who were treated at Kaizuka Hospital for CIN3 were analyzed for follow-up interval. Three months after conization, cervical cytology abnormalities were detected in 21 of 94 patients: atypical squamous cells of undetermined significance (ASC-US) in four cases; atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion (ASC-H) in one case; low-grade squamous intraepithelial lesions (LSIL)in 13 cases ; and atypical glandular cells (AGC) in three cases. Among these, cervical cytology anomalies were found to have recurred in six cases after six months ; two cases were ASC-US, three cases were LSIL, and one case was HSIL. Patients whose cytology was LSIL or HSIL underwent a colposcopic directed biopsy. These patients were found to have chronic inflammation or mild dysplasia. As a result, no patients who received follow-up post-conization cytology required additional treatment six months post-conization. We concluded that follow-up post-conization cytology is needed six months post-conization. Further study is required to clarify the appropriate follow-up interval for cervical cytology. [Adv Obstet Gynecol, 66 (1) : 6-10, 2014 (H26.2)]