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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
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Obstetrics and Gynegology2024№4
Recurrence of cervical intraepithelial neoplasia:...

Recurrence of cervical intraepithelial neoplasia: modern view on the problem

DOI
https://dx.doi.org/10.18565/aig.2024.4

Klinyshkova T.V., Buyan M.S., Samosudova I.B.

1) Omsk State Medical University, Ministry of Health of Russia, Omsk, Russia; 2) Gynecological Hospital, Omsk, Russia; 3) Clinical Diagnostic Center "Ultramed", Omsk, Russia

Despite the high effectiveness of excision treatment in patients with CIN 2+, there is an increased risk of cervical cancer in patients who underwent treatment. An increased risk of cervical cancer is associated with the recurrence of precancerous lesions, which reaches 14.4%. A number of scientific studies have proven that a woman’s age, CIN at resection margins, positive HPV test, and abnormal cytology after treatment are predictors of the CIN recurrence. Given the correlation of the persistence of high-risk human papillomavirus (HPV) after conization with the risk of recurrence, it is necessary to repeat a negative HPV test in the dynamics of observation. It was possible to identify the independent risk factors for the persistence/recurrence of CIN using the assessment of the status of the CIN excision margins. These factors are a positive endocervical margin or both resection margins in comparison with the ectocervical margin. The combination of a positive resection margin and persistence of HPV type 16 significantly increases the risk of the persistence/recurrence of CIN 2+. A negative co-test after conization in the dynamics of observation contributes to a favorable prognosis. In order to prevent the recurrence, it is proposed to use a preventive HPV vaccine after excision treatment of CIN that can reduce the development of the CIN 2+ recurrence. The results of the studies show to date that it is necessary to continue the search for optimization of vaccination.
Conclusion: A multi-stage comprehensive approach, which includes the detection of cervical papillomavirus infection after excision treatment of CIN, assessment of the radicality of resection, as well as the subsequent active monitoring, makes it possible to prevent the recurrence and progression of precancerous lesions of the cervix.

Authors’ contributions: Klinyshkova T.V. – developing the concept and design of the study, editing the article; Buyan M.S., Samosudova I.B. – searching and analyzing the material; Klinyshkova T.V., Buyan M.S. – writing the text.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Klinyshkova T.V., Buyan M.S., Samosudova I.B. Recurrence of cervical intraepithelial neoplasia: modern view on the problem.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (4): 34-38 (in Russian)
https://dx.doi.org/10.18565/aig.2024.4

Keywords

CIN
HSIL
human papillomavirus
conization
recurrence
margin status
posttreatment surveillance
Full text (in Russian)

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Received 15.01.2024

Accepted 02.04.2024

About the Authors

Tatiana V. Klinyshkova, Dr. Med. Sci., Professor, Professor of the Obstetrics and Gynecology Department, Omsk State Medical University, Ministry of Health of Russia, 644099, Russia, Omsk, Lenina str., 12, klin_tatyana@mail.ru, https://orcid.org/0000-0002-0544-8184
Maria S. Buyan, PhD, obstetrician-gynecologist, Gynecological hospital, 644052, Russia, Omsk, 22nd Рarty congress str., 4, mam_agata@mail.ru,
https://orcid.org/0000-0002-8413-3809
Irina B. Samosudova, PhD, obstetrician-gynecologist, Clinical Diagnostic Center "Ultramed", Russia, Omsk, Chkalova str., 12, i.samosudova@mail.ru,
https://orcid.org/0000-0002-2853-0471
Corresponding author: Tatiana V. Klinyshkova, klin_tatyana@mail.ru

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