Aim: Invasive cervical cancer is proceeded by a phase of preinvasive disease that is slow to progress and can be detected, treated, and collectively referred to as cervical intraepithelial neoplasia (CIN). Several excisional and ablative treatments for CIN have been studied, with loop electrosurgical excision procedure (LEEP) and cryotherapy being the two most commonly utilized. The objective of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to compare the compare harms and benefits of LEEP versus cryotherapy in women with CIN.
Methods: Electronic databases were searched from their inception until May 2018. We included all RCTs comparing cryotherapy versus LEEP in women with CIN. We included trials evaluating both HIV-seropositive and HIV-seronegative women. The primary outcome was the persistence of the disease at 6-month follow-up. Meta-analysis was performed using the random-effects model to produce summary treatment effects in terms of relative risk (RR) with 95% confidence interval (CI).
Results: Four trials, including 1035 women with CIN, were identified as relevant and included in the meta-analysis. Women who received LEEP for CIN had a significantly lower persistence at 6-month follow-up biopsy (RR: 0.87, 95% CI: 0.76-0.99) and significantly lower recurrence at 12-month follow-up biopsy (RR: 0.91, 95% CI: 0.84-0.99) compared to those who received cryotherapy. No between-group differences were found in the complications rate, but the analyses were not powered for these outcomes.
Conclusions: In women with CIN, treatment with LEEP was associated with a significantly lower risk of persistence disease at 6 months and recurrence disease at 12 months compared to treatment with cryotherapy.
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http://dx.doi.org/10.4103/GMIT.GMIT_56_18 | DOI Listing |
Int J Gynaecol Obstet
January 2025
Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan.
Objectives: To assess hotspot micro-vessel flow velocity waveforms in human papillomavirus (HPV) cervical infections using transvaginal power Doppler ultrasound (TV-PDU) and explore associations with high-grade squamous intraepithelial lesions (HSIL, cervical intraepithelial neoplasia [CIN] II and III).
Methods: In all, 62 patients with confirmed HPV-HSIL (14 CIN II, 48 CIN III) and 65 age- and parity-matched women with neither HPV infection nor CIN were compared. Seven parameters by TV-PDU were used to assess vascular classification and micro-vessel flow velocity, including vascular grading (class I, II, III), lowest pulsatility index (PI), resistance index (RI), peak systolic velocity (PS), end-diastolic velocity (ED), time average maximum velocity (TAMV), and the vascular index (VI = PS/ED).
AIDS
January 2025
Botswana Harvard Health Partnership, 1836 Northring Road, Gaborone, Botswana.
Objective: To evaluate the impact of ART duration and CD4 count on risk for high grade cervical dysplasia in women with HIV (WWH) compared to women without HIV in the treat-all era with integrase strand inhibitors (INSTIs).
Design: Prospective longitudinal cohort study in Botswana.
Methods: From February 2021 to August 2022, baseline HPV self-sampling was offered to women with and without HIV.
Int J Womens Health
January 2025
Department of Gynecology, Hebei Petro China Center Hospital, Langfang, People's Republic of China.
Objective: To analyze the relationship and predictive value of Netrin-1 expression and ultrasonic blood flow parameters with the severity of cervical intraepithelial neoplasia (CIN).
Methods: A retrospective analysis was performed on 115 patients diagnosed with CIN and 37 patients with chronic cervicitis, all of whom underwent surgical intervention. The expression levels of Netrin-1 were evaluated through immunohistochemical staining and quantitative fluorescence PCR.
J Clin Med
December 2024
Gynaecology Clinic, Riga East Clinical University Hospital, Hipokrata Street 2, LV 1079 Riga, Latvia.
: The study aimed to investigate the efficacy of medication treatment with glycyrrhizinic acid for cervical intraepithelial neoplasia (CIN) 1 lesions. : Women with histologically confirmed CIN 1 in cervical biopsies were included in the prospective study. Participants of the study group used glycyrrhizinic acid spray (Epigen spray) topically 10 days (Epigen 10-day subgroup) or 20 days (Epigen 20-day subgroup) per month for 6 months.
View Article and Find Full Text PDFJ Trauma Stress
January 2025
Center for Mental Health Outcomes Research (CeMHOR), Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas, USA.
Despite a varied selection of available trauma-focused evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD), few veterans receive a full course of an evidence-based treatment. A better understanding of and alignment with veterans' PTSD treatment goals could be one way to improve treatment engagement and adherence, consistent with veteran-oriented care within the U.S.
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