Regeneration of cervix after excisional treatment for cervical intraepithelial neoplasia: a study of collagen distribution

Please cite this paper as: Phadnis S, Atilade A, Bowring J, Kyrgiou M, Young M, Evans H, Paraskevaidis E, Walker P. Regeneration of cervix after excisional treatment for cervical intraepithelial neoplasia: a study of collagen distribution. BJOG 2011;118:1585–1591. Objective To study the distribution of collagen in the regenerated cervical tissue after excisional treatment for cervical intraepithelial neoplasia (CIN). Design Cohort study. Setting A large tertiary teaching hospital in London. Population Women who underwent repeat excisional treatment for treatment failure or persistent CIN. Methods Eligible women who underwent a repeat excisional treatment for treatment failure, including hysterectomy, between January 2002 and December 2007 in our colposcopy unit were identified by the Infoflex® database and SNOMED encoded histopathology database. Collagen expression was assessed using picro‐Sirius red stain and the intensity of staining was compared in paired specimens from the first and second treatments. Main outcome measure Differences in collagen expression were examined in the paired excisional treatment specimens. Results A total of 17 women were included. Increased collagen expression in the regenerated cervical tissue of the second cone compared with the first cone was noted in six women, decreased expression was noted in five women, and the pattern of collagen distribution was equivocal in six women. Conclusion There is no overall change in collagen distribution during regeneration following excisional treatment for CIN.