Article Text
Abstract
Introduction/Background Cervical glandular intraepithelial neoplasia (CGIN) is a premalignant lesion of the uterine cervix. Excision of CGIN is the goal of treatment, often requiring a large loop excision of the transformation zone (LLETZ) and close follow-up due to high risk of recurrence and residual disease. This study aims to review the management of CGIN in a tertiary center.
Methodology We selected all cytology-based glandular disease referrals to our center, between 2015 and 2022. Patients underwent a colposcopy assessment followed by excisional treatment of glandular disease and follow-up according to the United Kingdom guidelines. Data was collected on patient‘s age, smoking status, parity, colposcopy impression, diagnostic biopsy vs LLETZ, number and types of treatment, LLETZ depth and margins, and recurrence status. We used Microsoft Excel for statistic analysis.
Results Our sample consists of 33 patients with a mean age of 35 years(±7.7), of which 14 (42%) are nulliparous and 5 (15%) smoke. All patients underwent a colposcopic examination and epithelial changes were documented in 24 (73%) cases. A biopsy was taken in 23 (70%) patients, but only 9 (39%) showed glandular disease. The remaining 10 (30%) patients had a diagnostic LLETZ, with a 10/10 (100%) detection rate for glandular disease. Apart from one case, all 32 (97%) patients had a LLETZ. Mean depth of excision was 12.7mm(±4.1). Endocervical, ectocervical and radial margins were positive in 15 (47%), 9 (28%) and 7 (22%) cases respectively, therefore 15 (47%) patients required an additional procedure – repeat LLETZ, trachelectomy or hysterectomy. Overall, 26 (81%) histopathology results confirmed CGIN, 2 (6%) adenocarcinoma in situ and 2 (6%) cervical adenocarcinoma. To date, 28 patients (87%) remain free of disease, while 4 (13%) lost follow-up.
Conclusion In our study, 47% patients required two or more excisional procedures to treat glandular disease. To date, 87% of patients remain free of disease.
Disclosures None