RISK FACTORS ASSOCIATED WITH PERSISTENCE, RECURRENCE AND PROGRESSION OF CERVICAL INTRAEPITHELIAL NEOPLASIA (CIN) AFTER COLD KNIFE CONIZATION

Abstract

Objective: The aim of this study was to evaluate the significant risk factors that influence on persistence, recurrence and progression of CIN after cold-knife conization (CKC) Design: Prospective follow-up study. Methods: We retrospectively analyzed the likelihood of recurrent/residual disease in 143 pa-tients (mean age 39, 3 years, range 22 to 58 years) who underwent cold knife conization for CIN at the General Hospital Remedika, Department for Gynecology and Obstetrics, Skopje, Mace-donia in a period of 5 years. Results: Women with HR- HPV DNA after cold knife conization had a 17,5 % risk of reccur-ence, whereas 0,8% of women with absent HR – HPV DNA were with recurrent/persistent CIN. Conclusion: Persistence of HR-HPV DNA was only significant risk factor for recurrence and progression of cervical intraepithelial neoplasia (CIN) after Cold Knife Conization. Women with post-treatment HR-HPV types should be carefully followed-up every 4 months in a period of 2 years and all cytology abnormalities, followed by histological verification should be appropriately treated. Long-term follow-up strategy is obligatory because HR-HPV infection plays a predominant role in the pathogenesis of pre-invasive and invasive cervical cancer.