Diagnostics of residual/recurrent of precancerous lesions of the cervix after electroexcision
The objective of the study was to assess various risk factors for persistence of lesion after treatment of CIN 2, 3, and also to determine the significance of HPV testing for identification of residual/recurrent lesions. 157 patients with a histologically verified diagnosis of CIN 2, 3 were observed after loop electrosurgical excision procedure by using cytological investigation, HPV testing and colposcopy. Cytological investigation and HPV testing were performed on a single liquid-based cytological specimen. Residual lesions were identified in 14 patients: in 5 - HPV-effect/CIN 1, in 9 - CIN 2, 3. The results of the study showed that a high viral load and involvement of the endocervical glands were predictors of ineffective treatment of CIN 2, 3. Cytological investigation demonstrated a lesser diagnostic effectiveness in post-therapy monitoring of CIN 2, 3 than HPV testing. HPV testing performed 6 months after treatment, having 100% sensitivity and a 100% prognostic value of the negative result preserved good specificity (86%), which was considerably higher than the analogous values of Pap test. Therefore, HPV testing enhances the efficacy of post-therapy monitoring of precancerous lesions of the cervix