Loop Electrosurgical Excision Procedure in Managing Persistent Low-Grade Abnormality or Human Papillomavirus Positivity.

Autor:	Leung SOA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, McGill University Health Centre, McGill University, Montreal, QC., Vitonis AF; Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA., Feldman S; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Dana-Farber Cancer Institute, Boston, MA.
Jazyk:	angličtina
Zdroj:	Journal of lower genital tract disease [J Low Genit Tract Dis] 2021 Oct 01; Vol. 25 (4), pp. 281-286.
DOI:	10.1097/LGT.0000000000000619
Abstrakt:	Objectives: The aims of the study were to estimate the rate and to identify predictors of high-grade abnormalities among women with persistent low-grade abnormalities or high-risk human papillomavirus (hrHPV) positivity for at least 2 years stratified by presence (high risk) or absence (low risk) of previous high-grade results or HPV 16/18. Materials and Methods: A retrospective cohort study of patients who underwent a loop electrosurgical excision procedure (LEEP) for persistent low-grade or hrHPV positivity was performed. Patients were stratified based on whether they had a history of high-grade and/or HPV 16/18 positivity. Rates of high-grade or worse abnormalities on LEEP were compared using Fisher exact tests. Logistic regression was used to evaluate the associations between patient characteristics and high-grade results on the LEEP. Results: Three hundred eleven LEEPs were performed for persistent low-grade or hrHPV positivity. The rates of occult high grade were 12% and 22% among the low- and high-risk groups, respectively. Compared with those 45 years and older, the adjusted odds of high grade was 3.79 (95% CI = 1.19-12.1) for women aged 25-29 years. The odds of high grade was higher among current versus never smokers (6.40; 95% CI = 2.01-20.4) and those with a history of high-grade abnormality (2.23; 95% CI = 1.12-4.43). At 2 years, approximately half had an abnormal cytology and/or hrHPV positivity result independent of whether high grade was identified on their LEEP specimen. Conclusions: Patients with persistent low-grade abnormalities or persistent hrHPV should be counseled on the risks and benefits of a LEEP given that 12%-22% have a risk of occult high grade, especially if they have a history of high-grade dysplasia. Competing Interests: The authors have declared they have no conflicts of interest. (Copyright © 2021, ASCCP.)
Databáze:	MEDLINE
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