LEEP at CIN II/ III with positive margins-- recurrence of second leep?! Hi all! Doc recommended a Cold Knife Cone. Positive LEEP surgical margin was found in 167 cases (30.5 %). Says its more accurate than a Leep.. Feb 2021: Surgery-Cold Knife Cone & re-testing for HPV. 145/227 were confirmed as having CIN in the LEEP specimen. Results from second LEEP; Abnormal Pap after second LEEP; SECOND LEEP; Just made an appointment for my second LEEP... preparing for my second LEEP 13 and Johnson et al. In our study, the rate of persistent infection from HPV 16, after LEEP, was 15.9% (29/182) with 94% (17/18) of the recurring disease occurring within 18 months of follow up. Positive margins - Normal Post-Leep Pap: kmas: Cancer: Cervical & Ovarian: 3: 12-06-2003 07:33 AM: had a leep, clear margins still worry?? The purpose of this study was to determine if colposcopy with biopsy is necessary following a high‐grade Pap smear before treatment decision, and also to identify risk factors associated with an increased risk of … A procedure called a loop excision electrocautery procedure (aka LEEP) may be indicated when a patient receives an abnormal Pap smear result, usually after visualizing the cervix and/or lesion with colposcopy.. Pap smear histology is graded on a scale of negative, ASC-US, CIN 1, CIN 2, and CIN 3. Women whose LEEP biopsy specimen had positive margins were significantly more likely to have residual HSIL on follow-up than women whose specimens had negative margins (Table 1). Posts: 36 Positive Margins on Leep Results. The persistence rate among women with positive LEEP specimen margins was higher than among women with negative margins. These specimens are … Cuello et al. … When performing the LEEP operation, the lesion tissue should … Among 79 margin positive cases, 33 (41.7%) had re-LEEP, 13 (16.5%) had cold-knife conization, 13 (16.5%) had hysterectomy, and 12 (15.1%) were just followed-up while 8 (10.2%) were lost to follow up after the LEEP procedure. When LEEP margins are positive, there is a higher likelihood that abnormal cells are left behind in the cervix, when compared to when the margins are negative. Multivariate logistic analysis showed that age, positive margins, abnormal cytology, and positive hrHPV during follow-up … men (in mm3) in the LEEP procedure (p = 0.033) and the positive surgical margin (p =0.012). I've heard many negatives about that surgery in … 11 found significant recurrence associated with positive endocervical, but not ectocervical margins. TODAY: CLEAR MARGINS (YAYYYYYYY) NEGATIVE HPV. Among patients who had re-LEEP or conization (n=46), 7 patients (15,2%) had still positive surgical margine after the second procedure (5 in re-LEEP … I took an Ibuprfen for very light pain. Results: In our study, the rate of persistent infection from HPV 16, after LEEP, was 15.9% (29/182) with 94% (17/18) of the recurring disease occurring within 18 months of follow up. Recurrence rate for the median follow‐up time of 2 … LEEP margin status was also strongly related to HSIL on histology at week 26 or 52 with this occurring in 39 of 91 (49.9%) women with LEEP margins positive for HSIL compared with 16 of 62 (19.5%) women without this result (OR, 3.1 [95% CI, 1.56–6.14]; P = .0013). Tested positive for 8 high risk strains including 16. A multivariable model was not attempted as LEEP margin status and LEEP biopsy result are strongly related. After LEEP, Brockmeyer et al. Post Second LEEP; i had my second leep oct 17 and just got the results; has anyone had a second LEEP? The oncology surgeon who followed up with me after that told me to give it two months, then we'd do a pap and see how it went. A total of 248 women underwent LEEP–Cone. It really wasn't bad at all. We performed univariable statistics to identify factors associated with positive margins and then logistic regression modeling on significant factors for the outcome of positive margins. Objective: The study was performed to determine whether the human papillomavirus (HPV) genotype result from the HPV DNA chip test (HDC) was predictive of recurrent high-grade cervical intraepithelial neoplasia (CIN2-3) in patients with positive margins after a loop electrosurgical excision procedure (LEEP).Methods: A total of 184 patients with histologically confirmed … A positive margin was defined as HSIL on either the endocervical or ectocervical margin of the LEEP specimen or in endocervical curettage specimen after LEEP. I was terrified when diagnosed with High Risk HPV. RESULTS: Two hundred … I've been diagnosed with cervical dysplasia (loop electrosurgical excision procedure), CIN 2/3 and had both LEEP and conization done with still positive margins (all this in less than a year after a normal Pap smear). Women with hr HPV but whose margin … Furthermore, when the one-piece and two-piece LEEP specimens were analysed separately, the one-piece LEEP specimens had a significantly higher rate of positive margins (81.0%) compared with CKC (34.2%), but there was no significant difference in the rate of positive margins between two-piece LEEP (50.0%) and CKC (34.2%). 66/145 (45%) had involved (positive) margins, and 79/145 (55%) had noninvolved (negative) margins. By continuing to browse this site you are agreeing to our use of cookies. We calculated the Odds Ratio (OR) of women with peristent HPV 16 infection and positive margin, to have a recurrence. The positive margin of LEEP specimen especially the cone top status was a significant risk factor for residual/recurrent disease after LEEP. Ectocervical or endocervical margins were negative after repeat LEEP conization in the majority of women, except for 2 patients (3.6%) with CIN 3 and positive ectocervical margins. It is also argued that the tissue margins in a LEEP biopsy may show significant thermal artefact, which can interfere with the pathological assessment of biopsy margins.5 6 Some studies have shown a greater risk of a positive endocervical margin with LEEP but these have included cases in which AIS was not suspected prior to the excisional procedure.7–9 However, current … Univariate analysis found CIN III on histology and parity to be predictive of dysplasia in the top … The result of the follow-up colposcopy was not found to be significantly different based upon initial margin status (p=0.19), grade of dysplasia at the margin (p=0.3), or 3 depth of excision (p=0.8). Then he recommended to have a LEEP/CONE procedure done in the hospital. Cervical cone biopsies are performed with either a laser or surgical blade (cold knife) and result in a conical excision of cervical tissue centered on the os. Of these, 13 (87%) women had positive findings on follow-up, and 2 (13%) … My gynecologist is now recommending hysterectomy and I'm just wondering if there are any other options. Positive endocervical margins were associated with a higher rate of persistence than positive ectocervical margins. What is the next step? We performed univariable statistics to identify factors associated with positive margins and then logistic regression modeling on significant factors for the outcome of positive margins . 50.0% (33/66) of the patients with positive margins on the first pass had dysplasia or worse (CIN I–III or CA) in the second pass (top hat), compared to 6.6% (12/182) of the patients with a negative first pass (P < 0.0001). These traditional indications were evaluated in this study to assess the presence of dysplasia in the top hat and dysplasia found at the margin of resection in LEEP or LEEP–Cone specimens. status and 16 with a positive margin status on their initial LEEP. An electric current is passed through a wire loop … Auto text: “Insert Leep Cone” Background. So, he did an in-office biopsy and sent the tissue he got from my cervix and the lab results came back as dysplasia (HPV) positive - CIN 1. LEEP (loop electrosurgical excision procedure) is the preferred method of diagnosis and treatment of high-grade cervical intraepithelial neoplasia (CIN). Additionally, 2 multivariate analysis using the covariates listed above found no significant factors. These results suggest that a larger LEEP (i.e., a two-piece LEEP … A positive ECC has traditionally been an indication to perform a cold-knife conization or LEEP–Cone. Cervical cone biopsies and LEEPs (loop electrosurgical excision procedure) are both performed to remove pre-cancerous lesions from the cervix. Patients had follow‐up at three month intervals with Pap smears and indicated colposcopy/biopsy. 10-25% of LEEPs performed for a diagnosis of high grade squamous dysplasia will show recurrence of a high grade lesion during the subsequent follow up, regardless of the presence of dysplasia within the excision specimen (assuming adequate … Positive Margins on Leep Results; Positive Margins on Leep Results : Subscribe To Cancer: Cervical & Ovarian Thread Tools: Search this Thread: 10-14-2003, 08:11 AM #1: kmas Junior Member . Had a leep, results came back CIN3 with no clear margins. Therefore, after the operation, the high risk of the same sub-type HPV may indicate the future development of the CIN lesion. However, … There was no associ-ation between the treatment performed, the volume of the surgical specimen, and recurrence with negative or positive margins (p> 0.05). {{configCtrl2.info.metaDescription}} This site uses cookies. In summary, the positive incisal margin following LEEP operation is linked to relapse of the disease. First of all - I am so thankful for this message board and all of the support … In short, based on these results, patients with positive and negative LEEP findings should be treated and followed up similarly. The results showed that high-risk factors of positive ECC during follow-up were as follows: 1. positive ECC before LEEP, 2. involved margins of LEEP, 3. high-risk HPV infection during follow-up, and 4. abnormal LCT during follow-up. In multivariable analysis, multiparity and glandular involvement were two independent risk factors for positive LEEP surgical margin; adjusted relative risk of 8.10 (95% confidence interval, 3.82-17.20) and 14.10 (95% confidence interval, 8.34-23.83), respectively.Conclusions: The prevalence of positive margin … LEEP and conization were performed under colposcopic guide in local anesthesia in an outpatient facility by experienced personnel []; loops of different sizes were used according to lesion’s characteristics and cervix conformation; in all cases, care was taken to personalize the loop size.Excision margins were kept 2-3 mm out of the lesion, and completeness of lesion’s … HPV test at … The CIN grades, particularly 2 and 3, may indicate an … We calculated the Odds Ratio (OR) of women with peristent HPV 16 infection and positive margin, to have a recurrence. A positive margin was defined as HSIL on either the endocervical or ectocervical margin of the LEEP specimen or in endocervical curettage specimen after LEEP. When my doc told me there wasn't a treatment plan for eradicating the virus, I about shat myself. Indications for LEEP. Furthermore, the HPV 16 positive women with a negative margin, de- veloped 8 recurrences (40%). But my period has been weird lately, and I've suddenly … Does cin3 take long time to get since first infection of hpv Had a leep, results came back CIN3 with no clear margins. Join Date: Oct 2003. In addition to positive endocervical margins, 15 patients also had positive deep margins. It only took about 30 minutes and they gave me a general anesthesia. greenbean22: Cancer: Cervical & Ovarian: 7: 11-16-2003 12:35 PM: Positive Margins on Leep Results: kmas: Cancer: Cervical & Ovarian: 4: 10-14-2003 10:55 PM « Hello, I'm new, just had LEEP done for carcinoma in situ | … The risk of residual disease (abnormal cells that are left behind in the cervix after the LEEP) is reported to be as high as 25 percent when LEEP margins are positive, as opposed to 11 percent with negative margins… From this study it was found that the persistence of genotype 16 is … I had a LEEP 6 years ago that turned up positive margins. Of the 182 patients positive at the HPV test at T0 (be-fore LEEP), 144 (79.1%) were negative at 6months (T1) ... cases) with positive margin and 16 HPV positive have developed a recurrence (100%), while the hr HPV pa-tients (6 cases) only relapsed in one case. First, we found that a positive ECC before LEEP indicated a risk for positive ECC during follow-up (OR = 1.670). If combined with an HPV test, it is of some value for the prognosis of this disease. Well, it turned out ok. And I had 3-month checkups for a year or two, then 6-month PAPs ever since then, and each one has been clear. LEEP (loop electrosurgical excisional procedure) is one way to remove abnormal cells from the cervix by using a thin wire loop that acts like a scalpel (surgical knife). Conclusion Conservative treatment is an option in the treat-ment of AIS, for patients who desire fertility-sparing treat … & re-testing for HPV OR = 1.670 ) infection of HPV had LEEP... 167 cases ( 30.5 % ) had noninvolved ( negative ) margins for 8 high risk including... Leep.. Feb 2021: Surgery-Cold Knife cone & re-testing for HPV is of some value for the of. Ii/ III with positive endocervical margins, 15 Patients also had positive deep margins than a,... 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