00028: PREDICTIVE VALUE OF LOOP ELECTROSURGICAL EXCISION PROCEDURE (LEEP) MARGIN FOR CERVICAL INTRAEPITHELIAL NEOPLASIA (CIN) RECURRENCE

Introduction: Conisation is the treatment of choice for CIN. In most cases the lesions are completely removed, however, involvement of the resection margins may occur, leading to follow-up difficulties. The aim of this study is to investigate margins as an indicator of recurrence for CIN. Material and Methods: Retrospective charts and slides review of 385 successive CIN, all treated for CIN2 or CIN3 from 1997 to 2004, in our institution. Final histological analysis showed 8 (2%) cases of CIN I, 48 (12%) CIN II and 329 (85%) CIN III. LEEP was performed in 382 (99.2%) cases and cold knife in 3 cases (0.7 %). Mean age was 37.4 years (range 16-89) at operation time. Results: From the 385 cases, histological analysis showed disease free margins (DFM) in 298 (77.4%) cases and positive margins (PM) in 87 (22.6%). 39 (44.8%) were end cervical PM and 48 (55.2%) exoterically PM. At the 6 months follow up PAP smear, 295 (76.6 %) cases had normal results. Among the 87 cases with PM, 81 (90%) had normal results, 6 (7.4%) showed CIN1. In the CIN II group there were no recurrences in PM or DFM cases. In the CIN III group there were 5 (8.4%) recurrences in PM cases but 15 (24.5%) cases in the group with DFM had a recurrence. Conclusion: Margins criterion is not a good indicator of recurrence for CIN as reported in some published studies. Moreover, many relapses occur in DFM cases especially with CIN3 were new infection could be of major importance.