The correlation between patients demographic characteristics and the rate of persistent/recurrent high-grade CIN after conization
C. Maier, M. Mitran, R. Vlădăreanu, E. Brătilă
Rezumat: Introduction. Although there has been made great
progress in understanding the epidemiology of high-grade
cervical intraepithelial lesions (CIN 2/3), the cofactors
involved in the dynamics of cervical HPV infection are still a
subject of debate. The purpose of this paper was to assess
the patients’ demographic characteristics correlated with
the risk of lesions’ persistence/recurrence post-cervical
excisional therapy for CIN 2/3. Materials and method.
We conducted an analytical, observational, prospective
cohort study carried out in the “Prof. Dr. Panait Sîrbu”
Clinical Hospital of Obstetrics and Gynecology over a 3-year
period. We included 290 patients diagnosed with highgrade
cervical dysplasia who benefited from conization
in our clinic. The demographic variables obtained from
the anamnesis were statistically correlated with the rate
of persistent/recurrent cervical lesions post-therapy.
Results. The mean age for our study group was 44.1 years
old; more than half of the patients (73.1%) came from
urban environments and were highly educated (54.1%).
Regarding personal obstetrical history, most of the patients
were multiparous (71.3%), with 14.5% having more than
four births and 67.6% having delivered vaginally. The
mean age at the first sexual intercourse was 22.13 years
old, and more than half of the patients claimed never
having used the condom. Nine patients (3.1%) had been
diagnosed with immunodeficiency syndromes, out of
which six patients were HIV-positive. The multivariate
logistic regression analysis showed that age (OR=1.08;
p<0.01), smoking status (OR=3.96; p<0.01) and age at
first pregnancy (OR=0.87; p<0.01) were independent
predictive factors for the risk of persistence/recurrence
of CIN lesions. Conclusions. The three factors that were
statistically correlated with persistent/recurrent CIN after
therapy can be used as a predictive model for clinicians
struggling to prevent cervical neoplastic invasive lesions. Cuvinte cheie: CIN 2/3, persistence/recurrence rate, conization, demographic factors.