Potential cautery artifact at the margins precluding margin status. Tierney et al. These studies have also been limited by single institutional reviews or small sample size. The patients whose histological results show negative endocervical margins were accepted for cured. If dysplasia involves these small glands it is known as glandular involvement. An absence of neoplastic epithelium at all cone margins has been used as the general criterion for a negative conization margin [16, 19]. HPV HC2 tests before LEEP were positive in 170 (95.5%) of 178 patients. I had my LEEP last week and my results are in. LEEP usually takes only a few minutes, and you don’t need to prepare in any particular way. Also, avoid any heavy lifting or strenuous exercise for one week. The differ-ences in age, disease course and CIN level of the positive and The risk of CIN2+ after a negative LEEP did not differ by management strategy (log-rank, P = 0.85) or LEEP result (log-rank, P = 0.58). One patient had EGD near or at the margin and was followed for 75 months without recurrence. Hi, got my leep results today and my dr says she is not overly concerned, not the best possible news! Positive LEEP margin was more common among women with a positive LEEP (53.7% see-and-treat vs 42.6% conventional) compared with a negative result (0% see-and-treat vs 3.7% conventional, P < 0.0001). Ectocervical or endocervical margins were negative after repeat LEEP conization in the majority of women, except for 2 patients (3.6%) with CIN 3 and positive ectocervical margins. The results have shown that the patients with positive incisal margin and HPV had the highest deterioration rate. From 37 patients in total with different stage of dysplasia and carcinoma in situ hospitalized at Clinic of surgical gynecology for surgical treatment, in 33 (89%) there are negative endocervical margins. I return in 3 months. Background unremarkable endocervical epithelium" "3. In summary, the positive incisal margin following LEEP operation is … Seven of nine EGD specimens had negative margins. ... After all of this, I received the best news ever! Download Citation | Involved LEEP Excision Margins as Predictor of Residual/Recurrent Disease in HIV-positive and HIV-negative Women in a Low-resource Setting | … Based on those results my onc/gyn suggested three possible treatments: an endocervical excision with ecc ( done like the LEEP procedure) A cold knife cone Or hysterectomy Even though I am 38 and have no plans to have children ( tubal ligation done in 1990) I think that I will go with the cold knife cone. Here it goes DIAGNOSIS: 1) Moderate squamoud dysplasia Cin 11 showing focal involvement of the endocervical surgical The patients with a negative incisal margin and HPV exhibited the best prognosis. ... (0 replies) LEEP Results. During follow-up, 12 patients (6.6%) had residual/recurrent CIN 2+. Within the the endocervix there are endocervical glands. Objectives: To describe the prevalence and correlates of high-grade cervical intraepithelial neoplasia (CIN2+) after a negative loop electrosurgical excision procedure (LEEP), performed for high-grade squamous intraepithelial lesion (HSIL) cervical cytology. Of 14 patients, the margins of whose LEEP specimens were negative for dysplasia, 10 (71.4%) had at least one cytologic follow-up. Negative LEEP and High-Grade Dysplasia Data A recent article 2 sought to confirm the actual frequency of a negative LEEP, and to examine the clinical significance. The goal is to have negative margins. LEEP margin status was a significant predictive factor for persistent/recurrent disease. I got my LEEP results today. the abnormal cells extended to the margins of the sample. During LEEP, you will be in the same position as you are for a Pap test – lying on your back with your feet up in stirrups. It may be done in your doctor’s office, at a colposcopy clinic or at a hospital. Of these 10 patients with follow-up, 8 received an endocervical curettage at the time of LEEP, all of which were negative for dysplasia. Positive or close histopathological margins are associated with an increased risk of disease recurrence, but the risk in women with histologically negative margins is less clear, as earlier studies have demonstrated conflicting results. In most studies, cold knife conization is found to be the superior technique to achieve negative margins in the cone specimen. Four patients with two negative Papanicolaou smears and negative margins were observed for less than 1 year but were included in the no-recurrence category for purpose of analysis. The LEEP biopsy is concurrent with the CIN II/III findings of my colposcopy. There is 4 samples. Two EGD patients were lost to follow-up, one with a positive margin. Hi everyone! Following pathological diagnosis of the 120 cases included in the present study, 43 cases (35.8%) showed positive incisal margin, and 77 cases showed negative incisal margin (Table I). HELP!!! 27/57 (47%) with positive margins had recurrent disease compared with 22/65 (34%) with negative margins. Results Analysis of incisal margin condition of patients. The risk of CIN2+ after a negative LEEP did not differ by management strategy (log-rank, P = 0.85) or LEEP result (log-rank, P = 0.58). 145/227 were confirmed as having CIN in the LEEP specimen. 378 patients who underwent a LEEP procedure were selected, 306 of which had a … In those with a negative LEEP margin, post-LEEP cytology results were normal in mild in 40, 30, and severe in There was no correlation 7. between follow-up cytology result and positive or negative margin status (p=0.56). Results negative for both cytology and HPV X 2 _»cotesting in 3 years — if negative, return to routine screening If any test positive colposcopywith endocervical sampling CIN 2 + identified at surgical margins or on immediate post- procedure ECC Repeat cytology and ECC in 4-6 months (preferred) Repeat excision (acceptable) I have read several posts that mention that Leep results showed Clear Margins and that was a good thing. The inclusion criteria consisted of histologically verified CIN 2 and CIN 3 based on LEEP conization, and negative margins on pathological examinations in patients for whom both pre- and post-LEEP high-risk (HR) HPV test results (HCII) and pre-LEEP HR-HPV tests (HPV DNA chip assay) were available. Usually, a follow-up appointment will be recommended six months after your LEEP. The patients with a negative incisal margin and HPV exhibited the best prognosis. One of 760 (0.13%) patients had double-negative results of both cytology and hrHPV. My LEEP results were negative for HSIL! In those with a positive LEEP margin, post-LEEP cytology results were normal in 33 women, mild in 24, and severe in 10. My results came back that my outside margins were clear/negative (in the front) but the inward margin, into the canal, was positive. Of the 22 ACIS specimens, 15 had a negative LEEP margin. Your doctor will review your results with you within three weeks of the procedure. These patients formed the cured group. The results have shown that the patients with positive incisal margin and HPV had the highest deterioration rate. Recurrence was defined as none if the last two Papanicolaou smears were negative or if subsequent surgical tissue (ie, repeated LEEP, cold knife conization, or hysterectomy) had no … Several studies have investigated the influence of type of conization on margin status and results are controversial. I recently had a LEEP procedure and had not heard back from my doctor for a few days so I ordered a copy of the pathology report for myself. ... Women who have negative co-testing results twice can repeat co-testing in three years and return to routine screening if results are negative 52). Overall, the rate of incomplete resection varies between 27 % and 51 % [25, 27, 28•, 29]. One was lost to follow-up and the remaining 14 Even more so, the margins involved in HPV16 positive subjects is another prediction factor for relapse. I just got my leep results today: "1.Leep/Cone Biopsy: High-grade squamous intraepithelial lesion (severe squamous dysplasia - CIN 3)" "2. Information that was collected included patient characteristics, details regarding the initial LEEP specimens (e.g., depth, thickness and maximum diameter), histology of the first LEEP specimen and ECC specimen, number and location of involved margin sections, cervical cytology results, high-risk HPV results, biopsy and ECC findings during follow-up, and histology from the second LEEP … Recurrence rate for the median follow-up time of 2 years was 6.1% (3 patients). In summary, the positive incisal margin following LEEP operation is … Most concerning is the positive margins. LEEP biopsy: Cin3 is severe dysplasia without invasion (invasion = cancer). combined the results from 18 studies published in the literature and found that 18% of patients with negative margins still had residual AIS, and 2% had cancer. 66/145 (45%) had involved (positive) margins, and 79/145 (55%) had noninvolved (negative) margins. Consecutive LEEP specimens with a CIN 2-3 diagnosis (and whose margins were negative for the … Ectocervical or endocervical margins were negative after repeat LEEP conization in the majority of women, except for 2 patients (3.6%) with CIN 3 and positive ectocervical margins. This, along with cancer type, stage and lymph node status, will help you and your doctor choose the most effective follow-up treatment for you. The pathology report states: A) Uterus Cervix (LEEP): - High-grade squamous intraepithelial lesion (CIN3) extending to peripheral I called the office Friday afternoon but did not hear back and have been a wreck all weekend. The inclusion criteria consisted of histologically verified CIN 2 and CIN 3 based on LEEP conization, and negative margins on pathological examinations in patients for whom both pre- and post-LEEP high-risk (HR) HPV test results (HCII) and pre-LEEP HR-HPV tests (HPV DNA chip assay) were available. I cant make heads or tails out of this report! Read more about a … Methods: One hundred six women from our university-based colposcopy clinic underwent LEEP between 2007 and 2014. Results. Potential post-LEEP stenosis if crater rim is excessively cauterized. Obviously this means that they didn't get it all when they did the LEEP. Please contact your doctor if you haven’t heard from them. Once you've had a lumpectomy, you'll find out if your surgical margins were negative, positive, or close. ... (10 replies) LEEP Results on Friday. Among 183 patients, punch biopsies were CIN 2 in 31 (16.9%) and CIN 3 in 152 (83.1%). The American Society for Colposcopy and Cervical Pathology sponsored a consensus conference in 2001 to develop evidence-based guidelines for women with histologic abnormalities of … Patients had follow‐up at three month intervals with Pap smears and indicated colposcopy/biopsy. Conclusions: Our results show the importance of genotyping and that persistent HPV 16 infection should be study, 40% of relapses were in women with negative margin, but with persistent HPV 16 infection. In 19 cases of negative hrHPV, 18 available cytology reports were 5 HSIL, 4 ASC-US, 3 LSIL, 2 ASC-H, 2 AGC, 1 SCC, and 1 NILM. Herein, we evaluate the significance of finding CIN 1 at one or more margins of a LEEP specimen when these margins are negative for CIN 2-3. Positive LEEP margin was more common among women with a positive LEEP (53.7% see-and-treat vs 42.6% conventional) compared with a negative result (0% see-and-treat vs 3.7% conventional, P < 0.0001). I'm quoting the pathology report. However, due to the multifocal nature of the lesion (I am understanding correctly that this means "varying severity" of the lesion, right?) This represents a positive margin. 27 % and 51 % [ 25, 27, 28•, 29 ] 45 % ) involved. 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