Natural Course of Low Grade Squamous Intraepithelial Lesion

Saw, Ho Suk; Lee, Jae Kwan; Park, Yong Kyun

Abstract

OBJECTIVE: The purpose of this project was to suggest guidelines for management of Low grade Squamous Intraepithelial Lesion(LSIL) by evaluating natural course of LSIL of the uterine cervix. MATERIAL & METHODS: Among the women who visited Korea University Kuro Hospital from Jan. 1993 to Oct. 1998, One hundred fifty eight patients who were diagnosed as LSIL with colposcopy directed biopsy were followed up by colposcopy and/or cytology, HPV DNA test every 3 months. RESULT: In I58 patients who were diagnosed as LSIL, colposcopic examination confirmed progression to high grade intraepithelial lesion(HSIL) in 17(10.7%) patients, persistence of LSIL in 87(55%) patients, regression to normal in 54(34.2%) patients during the 3 year follow-up period. In prediction of LSIL subgroup, abnormal Pap test is 39%, 64%, 71% and abnormal HPV test is l6%, 29%, 65% in regression, persistent and progression group respectively. The shortest time of transition from minor lesion(LSIL) to high grade lesion was 12 months (the range, 12-51).
CONCLUSION
Of the patients who were diagnosed as LSIL and monitored by colposcopy for 60 months, 34% had disease that regressed, 55% had persistent disease, and 11% had progressive disease. HPV DNA test(p=0.002) is more informative than pap test(p=0.567) in prediction of disease progression.