2003, Number S3
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salud publica mex 2003; 45 (S3)
Cervical squamous and glandular intraepithelial neoplasia: Identification and current management approaches
Wright VC
Language: English
References: 87
Page: 417-429
PDF size: 632.35 Kb.
ABSTRACT
Certain types of human papillomaviruses (HPV) are associated with squamous intraepithelial lesions and cancer and these are termed high-risk. HPV type 16 is detected in approximately half of the high-grade squamous intraepithelial lesions and cancer. Because of the high rate of spontaneous regression of low-grade squamous lesions, follow-up by cytology, colposcopy and possible biopsy appears preferable. Due to the higher rate of progression to malignancy of the high-grade lesions conservative treatment is recommended. One of the most common reasons for persistence relates to the human immunodeficiency virus. Adenocarcinoma
in situ is an uncommon disorder and not well identified by cytologic sampling or colposcopic inspection. The diagnosis is made by cone biopsy, the specimen having negative margins for disease. Hysterectomy is the treatment procedure of choice unless fertility is an issue. Excisional methods (particularly electrosurgical loop) can interfere with accurate histological interpretation in some cases of both squamous disease and adenocarcinoma
in situ.
REFERENCES
Franco EL, Durante-Franco E, Ferenczy A. Cervical cancer: Epidemiology, prevention, and the role of the human papillomavirus infection. Can Med Assn J 2001;164:1017-1025.
Sellors JW, Loring AT, Mahony JB, Mielzynska I, Lytwyn A, Roth P et al. Comparison of self-collected vaginal, vulvar and urine samples for human papillomavirus testing to detect high-grade squamous intraepithelial lesions. Can Med Assn J 2000;163:513-518.
Bristow RE, Montz FJ. Human papillomavirus: Molecular biology screening applications in cervical dysplasia – A primer for primary care physicians. Prim Care Update Ob/Gyn 1998;5:238-246.
Ho GY, Burk RD, Klein S, Kadish AS, Chang CJ, Palan P et al. Persistent genital human papillomavirus infection as a risk factor for persistent dysplasia. J Natl Cancer Inst 1995;87:1365-1371.
Nagai Y, Maehamat T, Asato T, Kanazawa K. Persistence of human papillomavirus infections after therapeutic conization for CIN III. Is it an alarm for recurrence? Gynecol Oncol 2000;79:294-299.
Walboomers JMM, Jacobs MV, Manos MM, Bosch FX, Kummer A, Shah KV et al. Human papillomavirus is a necessary cause of invasive cancer worldwide. J Pathol 1999;189:12-19.
Andersson S, Rylander E, Larsson B, Strand A, Silfersvard C, Wilander E. The role of human papillomavirus in cervical adenocarcinoma carcinogenesis. Eur J Cancer 2001;37:246-250.
Riethdorf S, Riethdorf L, Milde-Langosch K, Park JW, Loning T. Differences in HPV 16 and HPV 18 E6/E7 oncogenic expression between in situ and invasive adenocarcinoma of the cervix uteri. Virchows Arch 2000; 437:491-500.
United States Public Health Service/Infectious Diseases Society of America. Guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. Ann Intern Med 1997;127:922-946.
Ellerbrock TV, Chiasson MA, Bush TJ, Sun XW, Sawo D, Brundley K et al. Incidence of cervical squamous intraepithelial lesions in HIV-infected women. JAMA 2000;283:1031-1037.
Sun XW, Kuhn L, Ellerbrook TV, Lungu O, Chiasson MA, Bush TJ et al. Human papillomavirus infection in women infected with the human immunodeficiency virus. N Engl J Med 1997;337:1343-1349.
Heard I, Jean-Michel T, Schmitz V, Mandelbrot L, Kazatchkine MD, Orth G. Increased risk of cervical disease among immunodeficiency. Virus-infected women with severe immunosuppression and human papillomavirus load. Obstet Gynecol 2000;96:403-409.
Moscicki AB, Ellenberg JH, Vermund SH, Holland CA, Darrah T, Crowley-Nowick PA et al. Prevalence of and risks for cervical human papillomavirus infection and squamous intraepithelial lesions in adolescent girls: Impact of infection with human immunodeficiency virus. Arch Pediatr Adolesc Med 2000;154:127-134.
Rozendaal L, Walboomers JMM, van der Linden JC, Voorhorst FJ, Kenemans P, Helmerhorot TJM et al. PCR-based high risk HPV test in cervical cancer screening gives objective risk assessment of women with cytomorophologically normal cervical smears. Int J Cancer 1996;68:766-769.
Nobbenhuis MAE, Walboomers JMM, Helmerhorst TJM, Tozendaal L, Remmink AJ, Risse AKT et al. Relation of human papillomavirus status to cervical lesions and consequences for cervical-cancer screening: A prospective study. Lancet 1999;354:20-25.
Meijer CJLM, Snijders PJF, Van den Brule AJC. Screening for cervical cancer: Should we test for infection with high risk HPV? Can Med Assn J 2000;163:535-538.
Östör AG. Natural history of cervical intraepithelial neoplasia: A critical review. Int J Gynecol Oncol 1993;12:186-192.
Naisell K, Roger V, Naisell M. Behavior of mild dysplasia during long term follow-up. Obstet Gynecol 1986;67:665-669.
McIndole WA, McLean MR, Jones RW, Mullins PR. The invasive potential of carcinoma in situ of the cervix. Obstet Gynecol 1984;64:451-458.
Campion MJ, McCane DJ, Cuzick J, Singer A. Progressive potential of mild cervical atypia, prospective cytologic, colposcopic and virologic study. Lancet 1986;2:237-240.
Schneider A, Meihardt G, Devilliers EM, Gisssman L. Sensitivity of the cytologic diagnosis of cervical condyloma in comparison with HPV DNA hybridization studies. Acta Cytopathol 1987;3:250-255.
Persad VL, Pierotic MA, Guijon FB. Management of cervical neoplasia: A 13 year experience. J Lower Gen Tract Dis 2001;5:199-203.
Mor-Yosef S, Lopes A, Pearson S, Monghan JM. Loop diathermy cone biopsies. Obstet Gynecol 1990;75:884-886.
Prendiville W, Cullimore J, Norman S. Large loop excision of the transformation zone (LLETZ): A new method of management for women with cervical intraepithelial neoplasia. Br J Obstet Gynaecol 1989;96:1054-1060.
Ferenczy A, Chouroun D, Arseneau J. Loop electrosurgical excision procedure for squamous intraepithelial lesions of the cervix: Advantages and potential pitfalls. Obstet Gynecol 1996;87:332-337.
Wright VC, Davies E, Riopelle MA. Laser surgery for cervical intraepithelial neoplasia: Principles and results. Am J Obstet Gynecol 1983;145: 181-185.
Duncan ID. The Semm cold coagulator in the management of cervical intraepithelial neoplasia. Clin Obstet Gynaecol 1983;26: 996-999.
Chanen W, Rome RM. Electrocoagulation diathermy in the treatment of cervical dysplasia and carcinoma in situ: A 15 year survey. Obstet Gynecol 1983;61:673-677.
Bryson SC, Lenehan P, Lickrish GM. The treatment of grade 3 cervical intraepithelial neoplasia with cryotherapy: An 11 year experience. Am J Obstet Gynecol 1985;151:201-205.
Wright VC. Carbon dioxide laser surgery for the cervix and vagina: Indications, complications and results. Comp Ther 1988;14:54-64.
Östör AG, Duncan A, Quinn M, Rome R. Adenocarcinoma in situ of the uterine cervix: An experience with 100 cases. Gynecol Oncol 2000;79: 207-210.
Anderson MC, Hartley RB. Cervical crypt involvement by intraepithelial neoplasia. Am J Obstet Gynecol 1980;55:546-549.
Boonstra H, Aalders JG, Koudstaal J, Oosrerhuis JW, Janssens J. Minimum extension and appropriate topographic position of tissue destruction for treatment of cervical intraepithelial neoplasia. Obstet Gynecol 1990;75:227-231.
Przybora LA, Plutowa A. Histologic topography of carcinoma in situ of the cervix uteri. Cancer 1959;12:268-273.
Carron RP, Gall EA. Preinvasive carcinoma and precancer metaplasia of the cervix. Am J Pathol 1954;30:15-19.
Scott RB, Reagan JW. Diagnostic cervical biopsy technique for the study of early cancer: Value of the cold-knife conization procedure. JAMA 1956;343-348.
Wright VC, Riopelle MA. The geometry of cervical intraepithelial neoplasia as a guide to its eradication. Cervix 1986;4:21-38.
Baldauff JJ, Dreyfus M, Ritter J, Meyer P, Philippe E. Risk of cervical stenosis after large loop or laser conization. Obstet Gynecol 1996;88: 933-938.
Lickrish GM. Colposcopy in the management of cervical intraepithelial neoplasia: Problems and suggestions. J Soc Obstet Gynaecol Can 2000; 22:429-434.
Montz FJ, Holschnidrer CH, Thompson CDR. Large loop excision of the transformation zone: Effect on pathologic interpretation of resection margins. Obstet Gynecol 1993;81:976-982.
Ioffe OB, Brooks SE, De Rezende RB, Silverberg SG. Artifact in cervical LLETZ specimens: Correlated with follow-up. Int J Gynaecol Pathol 1999;18:115-121.
Dalrymple C, Russel P. Thermal artifact after diathermy loop excision and laser cone biopsy. Int J Gynaecol Cancer 1999;9:238-242.
Baggish MS, Barash F, Noel Y, Brooks M. Comparison of thermal injury zones in loop electrical and laser cervical excisional conization. Am J Obstet Gynecol 1992;166:545-548.
Spitzer M, Chernys AE, Seltzer VL. The use of large loop excision of the transformation zone in an inner city population. Obstet Gynecol 1993;82:731-735.
Whitely PE, Olah KS. Treatment of cervical intraepithelial neoplasia: Experience with low-voltage diathermy loop. Am J Obstet Gynaecol 1990; 162:1272-1277.
Grundsell H, Alm P, Larsson G. Cure rates after conization for early cervical neoplasia. Ann Chir Gynecol 1993;72:218-222.
Mohamed-Noor K, Quinn MA, Tan J. Outcomes after cervical cold knife conization with complete and incomplete excision of abnormal epithelium: A review of 699 cases. Gynecol Oncol 1997;67:34-38.
Ostegard DR. Prediction of cervical clearance of cervical intraepithelial neoplasia by conization. Obstet Gynecol 1980;56:77-80.
Killackney MA, Jones WB, Lewis J, Jr. Diagnostic conization of the cervix: Review of 460 cases. Obstet Gynecol 1986;67:766-770.
Benedet JL, Anderson GH, Boyes DA. Colposcopic accuracy in the diagnosis of microinvasive and occult invasive carcinoma of the cervix. Obstet Gynecol 1985;65:551-561.
Schermerhorn TJ, Hodge J, Saztman AK, Hackett TE, Sprance HE, Harrison TA. Clinicopathologic variables predictive of residual dysplasia after cervical conization. J Reprod Med 1997;42:189-192.
Buxton EJ, Luesley DM, Wade-Evans T, Jordan JA. Residual disease after cone biopsy: Completeness of excision and follow-up cytology as predictive factors. Obstet Gynecol 1987;70:529-532.
Kolstad P, Valborg K. Long term follow-up of 1121 cases of carcinoma in situ. Obstet Gynecol 1976;48:125-129.
Jordan JA. Symposium on cervical dysplasia. I. Excisional methods. Colpos Gynecol Laser Surg 1984;4:271-274.
Creasman WT, Parkin RT. Management of early cervical neoplasia. Clin Obstet Gynecol 1975; 18:233-238.
Boyes DA, Worth J, Fidler HK. The results of 4389 cases of preinvasive cervical squamous carcinoma. J Obstet Gynaecol Br Commwlth 1979; 77:769-773.
Friedell GH, McKay DG. Adenocarcinoma in situ of the endocervix. Cancer 1953;6:887-897.
Gloor E, Hurlimann J. Cervical intraepithelial glandular neoplasia (adenocarcinoma in situ and glandular dysplasia). Cancer 1986;58: 1272-1282.
Cullimore JE, Luesley DM, Rollason TP, Byrne P, Buckley CH, Williams DR et al. A prospective study of conization of the cervix in the management of cervical intraepithelial glandular neoplasia (CIGN) - A preliminary report. Br J Obstet Gynaecol 1992;99:314-318.
Anderson MC. Glandular lesions of the cervix: Diagnostic and therapeutic dilemmas. Baillières Clin Obstet Gynaecol 1995;9:105-119.
Christopherson WM, Nealson N, Gray LA. Noninvasive precursor lesions of adenocarcinoma and mixed adenosquamous carcinoma of the cervix uteri. Cancer 1981;48:768-773.
Boon ME, Baak JPA, Kurver PJH. Adenocarcinoma in situ of the cervix. Cancer 1981;48:768-773.
Colgan TJ, Lickrish GM. The topography and invasive potential of cervical adenocarcinoma in situ, with or without associated dysplasia. Gynecol Oncol 1990;36:246-249.
Liu S, Semenci R, Mao Y. Cervical cancer: The increasing risk of adenocarcinoma and adenosquamous carcinoma in younger women. Can Med Assn J 2001;164:1152-1154.
Plaxe SC, Saltzstein SL. Estimation of the duration of the preclinical phase of cervical adenocarcinoma suggests there is ample opportunity for screening. Gynecol Oncol 1999;75:55-61.
Laverty CR, Farnsworth A, Thurlse J, Bowditch R. The reliability of a cytological prediction of cervical adenocarcinoma in situ. Aust NZ J Obstet Gynaecol 1988;28:307-312.
Mitchell H, Medley G, Gordon I, Giles G. Cervical cytology reported as negative and risk of adenocarcinoma of the cervix: No strong evidence of benefit. Br J Cancer 1995;71:894-897.
Wright VC, Shier RM. Colposcopy of adenocarcinoma in situ and adenocarcinoma – Differentiation from Other Cervical Lesions. Houston: Biomedical Communications, 2000.
Wright VC. Colposcopic features of cervical adenocarcinoma in situ and adenocarcinoma and management of preinvasive disease. En: Apgar B, Bronztman GL, Spitzer M. Colposcopy – Principles and practice. Philadelphia: WB Saunders, 2001:301-320.
Coppleson M, Atkinson KH, Dalrymple JC. Cervical squamous and glandular neoplasia: Clinical features and review of management. En: Coppleson M. Gynecologic Oncology. Edinburgh: Churchill Livingston, 1992: 571-607.
Muntz HG, Bell DA, Lage JM, Geoff BA, Feldman S, Rice LW. Adenocarcinoma in situ of the uterine cervix. Obstet Gynecol 1992;80:935-939.
Nicklin JL, Wright RG, Bell JR, Samaratunga H, Cox NC, Ward BG. A clinicopathological study of adenocarcinoma in situ of the cervix. The influence of cervical HPV infection and others factors, and the role of conservative surgery. Aust NZ J Obstet Gynaecol 1991;2:179-183.
Andersen ES, Arffman E. Adenocarcinoma in situ of the uterine cervix: A clinicopathologic study of 36 cases. Gynecol Oncol 1989; 35:1-6.
Bertrand M, Lickrish GM, Colgan TJ. The anatomical distribution of cervical adenocarcinoma in situ. Am J Obstet Gynecol 1987;1:21-26.
Wright VC, Dubuc-Lissoir J, Ehlen T, Heywood M, Plante M. Guidelines on adenocarcinoma in situ of the cervix: Clinical features and review of management. J Soc Obstet Gynaecol Can 1999;77:699-706.
Wright TC, Jr., Cox TJ, Massad LS, Twiggs LB, Wilkinson EJ. 2001 consensus guidelines for management of women with cervical cytological abnormalities. J Lower Gen Tract Dis 2002;6:127-143.
Thomas PA, Zalaski MS, Ohlhausen WW, Raab SS, Brenda JJ. Cytomorphologic characteristics of thermal injury related to endocervical brushing following loop electrosurgical excision procedure. Diagn Cytopathol 1996; 14:212-215.
Houghton SJ, Shafi MI, Rollason TP, Luesley DM. Is loop excision adequate primary treatment of adenocarcinoma in situ of the cervix? Br J Obstet Gynaecol 1997;104:325-329.
Poynor EA, Barakat RR, Hoskins WJ. Management follow-up of patients with adenocarcinoma in situ of the uterine cervix. Gynecol Oncol 1995;57:158-164.
Widrich T, Kennedy AW, Myers TM, Hart WR, Wirth S. Adenocarcinoma in situ of the uterine cervix: Management and outcome. Gynecol Oncol 1996;61:304-308.
Wolf JK, Levenback C, Malpica A, Morris M, Burke T, Follen Mitchell M. Adenocarcinoma in situ of the cervix: Significance of cone biopsy margins. Obstet Gynecol 1996;88:82-86.
Denehy TR, Gregori CA, Breen JL. Endocervical curettage, cone margins and residual adenocarcinoma in situ of the cervix. Obstet Gynecol 1997;90:1-6.
Im DO, Duska LR, Rosenshein NB. Adequacy of conization margins in adenocarcinoma in situ of the cervix as a predictor of residual disease. Gynecol Oncol 1995;59:179-182.
Luesley DM, Jordan JA, Woodman CBJ, Watson N, Williams DR, Waddell C. A retrospective review of adenocarcinoma-in-situ and glandular atypia of the uterine cervix. Br J Obstet Gynaecol 1987;94:699-703.
Hopkins MP, Roberts JA, Schmidt RW. Cervical adenocarcinoma in situ. Obstet Gynecol 1988;71:842-844.
Weisbrot IM, Stabinsky C, Davis AM. Adenocarcinoma in situ of the uterine cervix. Cancer 1972;29:1179-1187.
Kennedy AW, Tabbakh GH, Biscotti CV, Wirth S. Invasive adenocarcinoma of the cervix following LLETZ (Large Loop Excision of the Transformation Zone). Gynecol Oncol 1995;58:274:277.