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The value of the endocervical margin status in LEEP: analysis of 610 cases.

Authors
  • Mirandez, Camila Castelhano1
  • Yoneda, Juliana Yoko1
  • Gertrudes, Larissa Nascimento1
  • Carvalho, Carla Fabrine1
  • Derchain, Sophie1
  • Teixeira, Julio Cesar1
  • Vale, Diama Bhadra2
  • 1 Department of Obstetrics and Gynecology, University of Campinas, Rua Vital Brasil, 80 Cidade Universitária, Campinas, CEPSão Paulo, 13083-888, Brazil. , (Brazil)
  • 2 Department of Obstetrics and Gynecology, University of Campinas, Rua Vital Brasil, 80 Cidade Universitária, Campinas, CEPSão Paulo, 13083-888, Brazil. [email protected] , (Brazil)
Type
Published Article
Journal
Archives of Gynecology and Obstetrics
Publisher
Springer-Verlag
Publication Date
Sep 01, 2022
Volume
306
Issue
3
Pages
851–856
Identifiers
DOI: 10.1007/s00404-022-06464-w
PMID: 35220477
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To describe the results of 610 patients who underwent LEEP and evaluate factors related to a negative margin. A retrospective study of patients treated by LEEP at a colposcopy referral service in Campinas, Brazil, 2017-2019. Patients were referred to treat high-grade squamous intraepithelial lesion or adenocarcinoma in situ suspected by cytology and colposcopy (screen-and-treat) or by biopsy. Descriptive analysis was performed by frequencies as a function of the status of the margins (negative or positive). Factors associated with margin status were assessed by regression. The endocervical, ectocervical or both margins were negative in 82.4%, 75.7% and 65.9%, respectively. Age, sexual debut, parity, menopause status, smoking and hormonal contraception showed no difference in the proportion of negative margins. Both margins were negative in 66.1% of patients with transformation zone type(TZ) 1, 73.1% of TZ 2, and 54.7% of TZ 3 (p = 0.015). The endocervical negative margin was obtained in 78.0% of patients submitted to excision I (loop 10 mm) and 82.5% to excision II (loop 15 mm) (p = 0.016). Having the sexual debut at 18 years or older or being submitted to an excision type II doubled the chance of negative endocervical margin (1.98;1.04-3.77 and 1.95; 1.18-3.21, respectively). The proportion of negative endocervical margin was 78% in excision I and 86% in excision II. Sexual onset and excision type II increased the chance of obtaining a negative endocervical margin. © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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