Conservative Management of CIN2p16 Positive Lesions in Women with Multiple HPV Infection

Maria Teresa BrunoSara Boemi


The literature indicates a better agreement between pathologists of diagnosis of CIN2 when the H&E morphology is used together with p16 compared to the H&E morphology alone. The p16 protein when positive in a CIN2 suspect gives us the confidence of having selected true CIN2 cases. According to the 2006 American Society for Colposcopy and Cervical Pathology guidelines, positive CIN2 p16 in women over the age of 25 should be managed with excisional treatments. However, excisional treatments are associated with physical, psychological and obstetric morbidity and can have a negative impact on sexual function. In our study we sought to identify a clear management strategy, address the impact of routine use of p16 immunohistochemistry in this population and identify appropriate criteria for patient selection with the aim of reducing over-treatment.Method We studied the medical records of 130 patients who had undergone laser therapy for CIN2. Each patient underwent colposcopy, specific biopsy and HPV test. Patients were divided based on HPV infection into: single infections, multiple infections. All patients were tested for p16 protein, and then underwent ZTA laser therapy with follow-up.Statistical analysis Contingency tables...Continue Reading

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