Recurrence After Biopsy-Confirmed Cervical High-Grade Intraepithelial Lesion Followed by Negative Conization: A Systematic Review and Meta-analysis.

IF 2.4 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Lower Genital Tract Disease Pub Date : 2024-01-01 Epub Date: 2023-11-04 DOI:10.1097/LGT.0000000000000779

David Viveros-Carreño, Nathalia Mora-Soto, Juliana Rodríguez, José Alejandro Rauh-Hain, Pedro T Ramírez, Melissa López Varón, Kate J Krause, Carlos Fernando Grillo-Ardila, Jose Jeronimo, René Pareja

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引用次数: 0

Abstract

Abstract: The aim of the study is to assess the recurrence rate (as cervical intraepithelial neoplasia 2+ [CIN2+]) in patients who had a confirmed high-grade squamous intraepithelial lesion (CIN2-3) in a cervical biopsy specimen followed by a negative conization specimen.

Materials and methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Ovid/MEDLINE, Ovid/Embase, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched from inception until January 2023. The study protocol was registered in PROSPERO (ID number CRD42023393951). The search identified 3,089 articles; 1,530 were removed as duplicates, and 1,559 titles and abstracts were assessed for inclusion. The full text of 26 studies was assessed for eligibility, and finally, 12 studies with 1,036 patients were included. All included studies were retrospective cohort studies. A proportion meta-analysis was performed.

Results: For patients with negative conization specimens, the recurrence rate as CIN2+ during follow-up was 6% (95% CI, 1.8%-12.1%; I2 = 49.2; p < .0001, 215 patients and 4 studies) in the proportion meta-analysis, ranging from 0.3% to 13.0% for the individual studies. For patients with ≤CIN1 conization specimens, the recurrence rate as CIN2+ during follow-up was 3.6% (95% CI, 1.2%-7%; I2 = 75.1; p < .0001, 991 patients and 10 studies) in the proportion meta-analysis and ranged from 0.6% to 13.0% for the individual studies.

Conclusions: The recurrence rate as CIN2+ for patients with a confirmed high-grade intraepithelial lesion on a cervical biopsy followed by a negative conization specimen is 6%. In patients with negative and CIN1 conization specimens, the recurrence rate is 3.6%.

查看原文本刊更多论文

活检后复发证实宫颈上皮内高级别病变伴阴性Conization：系统回顾和荟萃分析。

摘要：本研究的目的是评估在宫颈活检标本和阴性锥切标本中确诊为高度鳞状上皮内病变（CIN2-3）的患者的复发率（如宫颈上皮内瘤变2+[CIN2+]）。材料和方法：根据系统评价和荟萃分析的首选报告项目清单进行系统文献综述。Ovid/MEDLINE、Ovid/Ebase、Cochrane对照试验中央登记册和ClinicalTrials.gov从开始到2023年1月进行了搜索。研究方案已在PROSPERO注册（ID号CRD42023393951）。搜索发现3089篇文章；1530篇被删除为重复，1559篇标题和摘要被评估为纳入。对26项研究的全文进行了资格评估，最终纳入了12项研究，涉及1036名患者。所有纳入的研究均为回顾性队列研究。进行了比例荟萃分析。结果：在比例荟萃分析中，对于锥切标本阴性的患者，随访期间CIN2+的复发率为6%（95%CI，1.8%-12.1%；I2=49.2；p<.00001215名患者和4项研究），个体研究的复发率在0.3%至13.0%之间。对于≤CIN1锥形化标本的患者，在比例荟萃分析中，随访期间CIN2+的复发率为3.6%（95%CI，1.2%-7%；I2=75.1；p<.00011991名患者和10项研究），个体研究的复发率在0.6%至13.0%之间。结论：宫颈活检后锥切标本阴性的患者，CIN2+的复发率为6%。在阴性和CIN1锥形化标本的患者中，复发率为3.6%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Lower Genital Tract Disease OBSTETRICS & GYNECOLOGY-

CiteScore

6.80

自引率

8.10%

发文量

158

审稿时长

6-12 weeks

期刊介绍： The Journal of Lower Genital Tract Disease is the source for the latest science about benign and malignant conditions of the cervix, vagina, vulva, and anus. The Journal publishes peer-reviewed original research original research that addresses prevalence, causes, mechanisms, diagnosis, course, treatment, and prevention of lower genital tract disease. We publish clinical guidelines, position papers, cost-effectiveness analyses, narrative reviews, and systematic reviews, including meta-analyses. We also publish papers about research and reporting methods, opinions about controversial medical issues. Of particular note, we encourage material in any of the above mentioned categories that is related to improving patient care, avoiding medical errors, and comparative effectiveness research. We encourage publication of evidence-based guidelines, diagnostic and therapeutic algorithms, and decision aids. Original research and reviews may be sub-classified according to topic: cervix and HPV, vulva and vagina, perianal and anal, basic science, and education and learning. The scope and readership of the journal extend to several disciplines: gynecology, internal medicine, family practice, dermatology, physical therapy, pathology, sociology, psychology, anthropology, sex therapy, and pharmacology. The Journal of Lower Genital Tract Disease highlights needs for future research, and enhances health care. The Journal of Lower Genital Tract Disease is the official journal of the American Society for Colposcopy and Cervical Pathology, the International Society for the Study of Vulvovaginal Disease, and the International Federation of Cervical Pathology and Colposcopy, and sponsored by the Australian Society for Colposcopy and Cervical Pathology and the Society of Canadian Colposcopists.