Chisele, Samson (2010) A Study on Histopathologic Outcomes of Women with Cryotherapy-Ineligible Lesions on Cervicography. Masters thesis, University of Zambia.
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Abstract
Objectives To determine the association between high grade cervical intraepithelial neoplasia (CIN 2+) and individual acetowhite cryotherapy-ineligible lesion types, as determined by cervicography. Design: a cross sectional study Setting: Gynecologic Cancer Prevention Unit of the University Teaching Hospital, Zambia. Population: Women referred to the study site for histologic evaluation of cryotherapy-ineligible lesions of the cervix were included in the study. Individual acetowhite lesion types which do not meet criteria for cryotherapy include those that (1) cover more than 75% of the transformation zone, (2) disappear into the endocervical canal, (3) contain abnormal vasculature (mosaicism, punctuations, or atypical blood vessels), and (4) are thick. Main outcome measures: Histologic diagnosis of high grade cervical intraepithelial neoplasia (CIN 2+) for each cryotherapy-ineligible acetowhite lesion type of the cervix. Results: A total of 130 women were enrolled into the study. Women with lesions occupying greater than 75% of the transformation zone had five fold greater odds of CIN 2+ than women with other lesions, OR 4.5 (95% CI 2.19.9), p < 0.001. Women with thick acetowhite lesions were less likely to have CIN 2+, OR 1.1 (95% CI 0.4 3.0), p=0.84. Women with lesions disappearing into the endocervix beyond complete visualization were far less likely to have CIN 2+, OR 0.1 (95% CI 0.040.45), p< 0.001. No association was detected between CIN 2+ and lesions with abnormal vessels. After multivariable adjustment, there remained a significant association between lesions covering greater than 75% of the transformation zone and CIN 2+, OR 2.2 (95% CI 1.43.4). However, other individual cryotherapy-ineligible acetowhite lesion types were no longer associated with CIN 2+. Conclusions: Cryotherapy-ineligible acetowhite lesions occupying greater than 75% of the transformation zone diagnosed on cervicography are associated with histopathologic outcome of high grade cervical intraepithelial neoplasia.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine > RG Gynecology and obstetrics |
| Divisions: | Africana |
| Depositing User: | JHI Africa |
| Date Deposited: | 23 Nov 2017 14:27 |
| Last Modified: | 23 Nov 2017 14:27 |
| URI: | http://thesisbank.jhia.ac.ke/id/eprint/2755 |
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