Margin clearance and HPV infection do not influence the cure rates of early neoplasia of the uterine cervix by laser conization

A lesion existing in the endocervical and/or ectocervical conized margin an d HPV-DNA existing in a conized specimen are reported to he at risk of pers istence or recurrence of early neoplasia of the cervix when treated by coni zation. The aim of this study was to investigate whether margin clearance a nd HPV infection influenced the outcome in our series of laser conization. Excisional conization with the KTP/YAG Surgical Laser System or Nd-YAG lase r was performed in this study. Eighty patients with cervical neoplasias wer e included: 47 with dysplasia, 25 with carcinoma in situ (CIS) and eight wi th microinvasive carcinoma. The endocervical and ectocervical conized margi ns were examined microscopically. HPV-DNA was analyzed with the primer for types 16, 18, 31, 33, 35, 52b and 58 amplified by the PCR method. The margi ns of the conized specimens were confirmed histopathologically to be clear in 58 cases (73%), whereas in 22 cases (27%) they were involved by neoplasi a. HPV-DNA was positive in 38% of dysplasias, 40% of CISs and 50% of microi nvasive carcinomas. The overall rate of the initial curl at 10 weeks after treatment appeared to he 100% in all 80 cases. primary cure rates were 100% for 47 cases with dysplasia, 96% for 24 cases with CIS and 100% for four c ases with microinvasive carcinoma regardless of margin positivity and HPV-D NA status. Involved margins and HPV infection did not influence the cure of early neoplasia of the uterine cervix; achieved by our laser conization pr ocedure. The favorable results may he due to the procedure of vaporizing th e cut surface forming a dome-shaped tissue defect.