Heterogeneity in CIN3 diagnosis
2008; Elsevier BV; Volume: 9; Issue: 5 Linguagem: Inglês
10.1016/s1470-2045(08)70110-4
ISSN1474-5488
AutoresMark Schiffman, Ana Cecilia Rodríguez,
Tópico(s)Cervical Cancer and HPV Research
ResumoIn this issue of The Lancet Oncology, McCredie and colleagues report retrospective, long-term follow-up of 1063 women diagnosed with cervical intraepithelial neoplasia 3 (CIN3) in Auckland, New Zealand, from 1955 to 1976. 1 McCredie MRE Sharples KJ Paul C et al. Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study. Lancet Oncol. 2008; 9: 425-434 Summary Full Text Full Text PDF PubMed Scopus (870) Google Scholar A histopathology diagnosis of CIN3 implies abnormal, precancerous cell growth that spans greater than two-thirds of the entire epithelium, and can involve the full thickness (carcinoma in situ). In the 1960s, Green incorrectly believed he could distinguish incipient cancer from CIN3 (which he considered aetiologically distinct) by colposcopic examination and directed biopsies. He withheld treatment from many women diagnosed between 1965 and 1974. As McCredie and co-workers report, the cumulative 30-year risk of invasive cancer in the 143 women with only diagnostic biopsies, but no treatment, was 31·3% (95% CI 22·7–42·3); and the cumulative risk was 50·3% (37·3–64·9) in the subset of women with cytological evidence of persistent CIN3 within 2 years of diagnosis. Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort studyThis study provides the most valid direct estimates yet available of the rate of progression from CIN3 to invasive cancer. Women with untreated CIN3 are at high risk of cervical cancer, whereas the risk is very low in women treated conventionally throughout. Full-Text PDF
Referência(s)