Obstet Gynecol Sci.  2017 Mar;60(2):200-206. 10.5468/ogs.2017.60.2.200.

Efficacy of loop electrosurgical excision procedure with cold coagulation for treating cervical intraepithelial neoplasia: A two center cohort study

• Kim HS
• Kwon JE
• Kim JH
• Kim A
• Lee NR
• Kim M
• Lee M
• Suh DH
• Kim YB

• KMID: 2372805
• DOI: http://doi.org/10.5468/ogs.2017.60.2.200

Abstract

OBJECTIVE
To evaluate the efficacy of loop electrosurgical excision procedure (LEEP) combined with cold coagulation for treating cervical intraepithelial neoplasia (CIN).
METHODS
We reviewed clinic-pathologic data of 498 patients treated with LEEP alone (n=354), and LEEP combined with cold coagulation (n=144) between January 2000 and December 2011. After LEEP, we followed up all patients by using Papanicolaou smear and human papillomavirus (HPV) test, and evaluated abnormal cervical cytology-free interval and high-risk HPV infection-free interval. Moreover, we investigated independent factors affecting abnormal cervical cytology or high-risk HPV infection after LEEP.
RESULTS
Abnormal cervical cytology-free interval was longer in patients treated with LEEP combined with cold coagulation than in those treated with LEEP alone (mean, 92.4 vs. 84.4 months; P=0.01), and patients treated with LEEP combined with cold coagulation also showed longer high-risk HPV infection-free interval than those treated with LEEP alone (mean, 87.6 vs. 59.1 months; P=0.01). Moreover, CIN 3 and cold coagulation were factors affecting abnormal cervical cytology after LEEP (adjusted hazard ratios, 1.90 and 0.61; 95% confidence intervals, 1.27 to 2.84 and 0.39 to 0.96), and CIN 3, positive deep cervical margin and cold coagulation were also factors affecting high-risk HPV infection after LEEP (adjusted hazard ratios, 2.07, 4.11, and 0.64; 95% confidence intervals, 1.38 to 3.08, 1.63 to 10.39, and 0.43 to 0.96). When we performed subgroup analyses for patients with CIN 2 or CIN 3, the result were similar.
CONCLUSION
LEEP combined with cold coagulation may be more effective for treating CIN than LEEP alone. Moreover, cold coagulation may decrease the risk of potential of recurrence after LEEP.

Keyword

Cervical intraepithelial neoplasia; Cold coagulation; Loop electrosurgical excisional procedure

MeSH Terms

Cervical Intraepithelial Neoplasia*
Cohort Studies*
Humans
Papanicolaou Test
Recurrence

Figure

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  Fig. 1 Comparison of abnormal cervical cytology-free interval and high-risk human papillomavirus infection-free interval between loop electrosurgical excision procedure (LEEP) combined with cold coagulation and LEEP alone in (A) all patients and (B) patient with cervical intraepithelial neoplasia 2 or 3.

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