HISTOPATHOLOGICAL FEATURES AND THERAPEUTIC OUTCOMES IN CERVICAL INTRAEPITHELIAL NEOPLASIA: A CROSS-SPECIALTY CLINICAL INVESTIGATION
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Keywords
Histopathological Features, Therapeutic Outcomes, Cervical Intraepithelial Neoplasia, Clinical Investigation
Abstract
Background: Cervical Intraepithelial Neoplasia (CIN) is a pre-cancerous condition associated with persistent infection by high-risk human papillomavirus (HPV). CIN is graded into three levels (CIN 1, CIN 2, CIN 3) based on histopathological features, with treatment strategies varying depending on the severity of the lesion. This study aims to assess the histopathological characteristics of CIN and evaluate therapeutic outcomes in a cohort of 75 patients.
Methods: This retrospective study analyzed 75 patients diagnosed with CIN between January 2020 and December 2020. Patients were classified by CIN grade and underwent different treatments, including conservative management, ablative therapies (cryotherapy, laser ablation), or excisional therapies (LEEP, conization), based on lesion severity. Therapeutic outcomes, including lesion resolution, recurrence, and progression, were tracked over a two-year follow-up period. Factors such as patient age, HPV type, immune status, and excision margin status were also analyzed for their impact on outcomes.
Results: Of the 75 patients, 42.7% had CIN 1, 29.3% had CIN 2, and 28% had CIN 3. Lesion regression was observed in 71.9% of CIN 1 patients managed conservatively. Recurrence was most frequent in CIN 3 (14.3%), followed by CIN 2 (18.2%) and CIN 1 (9.4%). Positive excision margins, high-risk HPV infection, and compromised immune status were significant predictors of recurrence. Patients with high-risk HPV strains had a 27% recurrence rate compared to 9% for other HPV types. Immune-compromised patients had a 60% recurrence rate compared to 15% for immunocompetent patients.
Conclusions: Histopathological features and therapeutic outcomes in CIN are strongly influenced by lesion severity, HPV type, immune status, and excision margins. While low-grade CIN often regresses, higher-grade lesions require aggressive intervention and close monitoring. Personalized treatment strategies based on patient characteristics and lesion factors are essential to optimize therapeutic success and minimize recurrence. The findings support the need for ongoing HPV vaccination and effective screening programs to prevent CIN progression to cervical cancer.
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Dr Fawad Hussain
Assistant Professor of Community Medicine. Niazi Medical & Dental College, Sargodha Pakistan
Dr Shazia Sultana
Associate Professor, Obstetrics and Gynecology. Ziauddin University, Karachi Pakistan
Dr Fareeha Naseer Syed
Assistant Professor of Pathology, CMH Multan Institute of Medical Sciences, Multan Pakistan
Dr Muhammad Imran Ashraf
Associate Professor, Pharmacology Department, Allama Iqbal Medical College, Lahore Pakistan
Dr Summyia Sadia
Assistant Professor, Forensic Medicine and Toxicology, Sargodha Medical College, Sargodha Pakistan
Dr Rao Salman Aziz
Associate Professor, Pharmacology Department, Rashid Latif Medical & Dental College, Lahore Pakistan