Endocervical crypt involvement by high-grade cervical intraepithelial neoplasia and its association with high-grade histopathological recurrence after cervical excision in women with negative excision margins: a systematic review and meta-analysis
Background There is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk factor for disease recurrence after cervical treatment. Objectives To provide a systematic review and meta-analysis on whether end...
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| Vydáno v: | Archives of gynecology and obstetrics Ročník 309; číslo 3; s. 939 - 948 |
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| Jazyk: | angličtina |
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Springer Berlin Heidelberg
01.03.2024
Springer Nature B.V |
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| ISSN: | 1432-0711, 0932-0067, 1432-0711 |
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| Abstract | Background
There is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk factor for disease recurrence after cervical treatment.
Objectives
To provide a systematic review and meta-analysis on whether endocervical crypt involvement by high-grade CIN on the excised cervical specimen is associated with high-grade histopathological recurrence during the follow-up of women after cervical excisional treatment.
Search strategy
We searched the Medline, Scopus, Central, and Clinical Trials.gov databases from inception till May 2023.
Selection criteria
Studies that reported on women with a single cervical treatment with any method of excision for CIN2 or CIN3 lesion, negative excision margins, and whose recurrence was defined histopathologically were included.
Data collection and analysis
Two reviewers independently evaluated study eligibility. We used the fixed effects model for meta-analysis.
Main results
There were 4 eligible studies included in the present systematic review that evaluated 1088 women treated with either large loop excision of the transformation zone (LLETZ) or with cold knife conization (CKC). We found no significant association of endocervical crypt involvement by CIN2-3 with high-grade histopathological recurrence at follow-up after cervical excision (OR 1.93; 95% CI 0.51–3.35). The subgroup analysis of women with LLETZ cervical excision showed again no significant association with high-grade histopathological recurrence at follow-up (OR 2.00; 95% CI 0.26–3.74).
Conclusion
Endocervical crypt involvement by high-grade CIN does not seem to be a risk factor for high-grade histopathological recurrence after cervical excision with negative excision margins. |
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| AbstractList | BackgroundThere is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk factor for disease recurrence after cervical treatment.ObjectivesTo provide a systematic review and meta-analysis on whether endocervical crypt involvement by high-grade CIN on the excised cervical specimen is associated with high-grade histopathological recurrence during the follow-up of women after cervical excisional treatment.Search strategyWe searched the Medline, Scopus, Central, and Clinical Trials.gov databases from inception till May 2023.Selection criteriaStudies that reported on women with a single cervical treatment with any method of excision for CIN2 or CIN3 lesion, negative excision margins, and whose recurrence was defined histopathologically were included.Data collection and analysisTwo reviewers independently evaluated study eligibility. We used the fixed effects model for meta-analysis.Main resultsThere were 4 eligible studies included in the present systematic review that evaluated 1088 women treated with either large loop excision of the transformation zone (LLETZ) or with cold knife conization (CKC). We found no significant association of endocervical crypt involvement by CIN2-3 with high-grade histopathological recurrence at follow-up after cervical excision (OR 1.93; 95% CI 0.51–3.35). The subgroup analysis of women with LLETZ cervical excision showed again no significant association with high-grade histopathological recurrence at follow-up (OR 2.00; 95% CI 0.26–3.74).ConclusionEndocervical crypt involvement by high-grade CIN does not seem to be a risk factor for high-grade histopathological recurrence after cervical excision with negative excision margins. Background There is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk factor for disease recurrence after cervical treatment. Objectives To provide a systematic review and meta-analysis on whether endocervical crypt involvement by high-grade CIN on the excised cervical specimen is associated with high-grade histopathological recurrence during the follow-up of women after cervical excisional treatment. Search strategy We searched the Medline, Scopus, Central, and Clinical Trials.gov databases from inception till May 2023. Selection criteria Studies that reported on women with a single cervical treatment with any method of excision for CIN2 or CIN3 lesion, negative excision margins, and whose recurrence was defined histopathologically were included. Data collection and analysis Two reviewers independently evaluated study eligibility. We used the fixed effects model for meta-analysis. Main results There were 4 eligible studies included in the present systematic review that evaluated 1088 women treated with either large loop excision of the transformation zone (LLETZ) or with cold knife conization (CKC). We found no significant association of endocervical crypt involvement by CIN2-3 with high-grade histopathological recurrence at follow-up after cervical excision (OR 1.93; 95% CI 0.51–3.35). The subgroup analysis of women with LLETZ cervical excision showed again no significant association with high-grade histopathological recurrence at follow-up (OR 2.00; 95% CI 0.26–3.74). Conclusion Endocervical crypt involvement by high-grade CIN does not seem to be a risk factor for high-grade histopathological recurrence after cervical excision with negative excision margins. There is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk factor for disease recurrence after cervical treatment. To provide a systematic review and meta-analysis on whether endocervical crypt involvement by high-grade CIN on the excised cervical specimen is associated with high-grade histopathological recurrence during the follow-up of women after cervical excisional treatment. We searched the Medline, Scopus, Central, and Clinical Trials.gov databases from inception till May 2023. Studies that reported on women with a single cervical treatment with any method of excision for CIN2 or CIN3 lesion, negative excision margins, and whose recurrence was defined histopathologically were included. Two reviewers independently evaluated study eligibility. We used the fixed effects model for meta-analysis. There were 4 eligible studies included in the present systematic review that evaluated 1088 women treated with either large loop excision of the transformation zone (LLETZ) or with cold knife conization (CKC). We found no significant association of endocervical crypt involvement by CIN2-3 with high-grade histopathological recurrence at follow-up after cervical excision (OR 1.93; 95% CI 0.51-3.35). The subgroup analysis of women with LLETZ cervical excision showed again no significant association with high-grade histopathological recurrence at follow-up (OR 2.00; 95% CI 0.26-3.74). Endocervical crypt involvement by high-grade CIN does not seem to be a risk factor for high-grade histopathological recurrence after cervical excision with negative excision margins. There is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk factor for disease recurrence after cervical treatment.BACKGROUNDThere is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk factor for disease recurrence after cervical treatment.To provide a systematic review and meta-analysis on whether endocervical crypt involvement by high-grade CIN on the excised cervical specimen is associated with high-grade histopathological recurrence during the follow-up of women after cervical excisional treatment.OBJECTIVESTo provide a systematic review and meta-analysis on whether endocervical crypt involvement by high-grade CIN on the excised cervical specimen is associated with high-grade histopathological recurrence during the follow-up of women after cervical excisional treatment.We searched the Medline, Scopus, Central, and Clinical Trials.gov databases from inception till May 2023.SEARCH STRATEGYWe searched the Medline, Scopus, Central, and Clinical Trials.gov databases from inception till May 2023.Studies that reported on women with a single cervical treatment with any method of excision for CIN2 or CIN3 lesion, negative excision margins, and whose recurrence was defined histopathologically were included.SELECTION CRITERIAStudies that reported on women with a single cervical treatment with any method of excision for CIN2 or CIN3 lesion, negative excision margins, and whose recurrence was defined histopathologically were included.Two reviewers independently evaluated study eligibility. We used the fixed effects model for meta-analysis.DATA COLLECTION AND ANALYSISTwo reviewers independently evaluated study eligibility. We used the fixed effects model for meta-analysis.There were 4 eligible studies included in the present systematic review that evaluated 1088 women treated with either large loop excision of the transformation zone (LLETZ) or with cold knife conization (CKC). We found no significant association of endocervical crypt involvement by CIN2-3 with high-grade histopathological recurrence at follow-up after cervical excision (OR 1.93; 95% CI 0.51-3.35). The subgroup analysis of women with LLETZ cervical excision showed again no significant association with high-grade histopathological recurrence at follow-up (OR 2.00; 95% CI 0.26-3.74).MAIN RESULTSThere were 4 eligible studies included in the present systematic review that evaluated 1088 women treated with either large loop excision of the transformation zone (LLETZ) or with cold knife conization (CKC). We found no significant association of endocervical crypt involvement by CIN2-3 with high-grade histopathological recurrence at follow-up after cervical excision (OR 1.93; 95% CI 0.51-3.35). The subgroup analysis of women with LLETZ cervical excision showed again no significant association with high-grade histopathological recurrence at follow-up (OR 2.00; 95% CI 0.26-3.74).Endocervical crypt involvement by high-grade CIN does not seem to be a risk factor for high-grade histopathological recurrence after cervical excision with negative excision margins.CONCLUSIONEndocervical crypt involvement by high-grade CIN does not seem to be a risk factor for high-grade histopathological recurrence after cervical excision with negative excision margins. |
| Author | Underwood, Martyn Tzavara, Chara Papoutsis, Dimitrios Parry-Smith, William |
| Author_xml | – sequence: 1 givenname: Dimitrios orcidid: 0000-0001-9921-1120 surname: Papoutsis fullname: Papoutsis, Dimitrios email: dpapoutsis@uowm.gr organization: Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospital NHS Trust, School of Health Sciences, University of Western Macedonia – sequence: 2 givenname: Martyn surname: Underwood fullname: Underwood, Martyn organization: Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospital NHS Trust – sequence: 3 givenname: William surname: Parry-Smith fullname: Parry-Smith, William organization: Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospital NHS Trust – sequence: 4 givenname: Chara surname: Tzavara fullname: Tzavara, Chara organization: Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37821642$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_26453_otjhs_1443698 crossref_primary_10_3390_cancers16173022 crossref_primary_10_3389_fonc_2025_1645322 |
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| Keywords | Large loop excision of the transformation zone Recurrence Excision margins Endocervical crypt involvement Cold knife conization Cervical intraepithelial neoplasia |
| Language | English |
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There is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may... There is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may represent a risk... BackgroundThere is a growing body of evidence suggesting that endocervical crypt involvement by high-grade cervical intraepithelial neoplasia (CIN) may... |
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| SubjectTerms | Cervix Uteri - pathology Cervix Uteri - surgery Conization - methods Endocrinology Female Gynecology Human Genetics Humans Margins of Excision Medicine Medicine & Public Health Neoplasm Grading Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - pathology Obstetrics/Perinatology/Midwifery Review Risk Factors Systematic review Uterine Cervical Dysplasia - pathology Uterine Cervical Dysplasia - surgery Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - surgery |
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| Title | Endocervical crypt involvement by high-grade cervical intraepithelial neoplasia and its association with high-grade histopathological recurrence after cervical excision in women with negative excision margins: a systematic review and meta-analysis |
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