PREGNANCY IN IN-SITU AND MICROINVASIVE CARCINOMA OF THE UTERINE CERVIX: CHANCES OF CARRYING PREGNANCY TO FULL TERM, SPECIFIC FEATURES OF DIAGNOSIS AND DISEASE COURSE, AND OUTCOMES AND PROGNOSIS


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Objective. To study the frequency of errors of a cytological method during pregnancy in suspected carcinoma of the uterine cervix in the smears and in the absence of a visible tumor and to determine the chance of carrying pregnancy to full term in the presence of in-situ (CIN3/CIS) and microinvasive carcinoma of the uterine cervix (MICUS). Subjects and methods. The study enrolled 102 pregnant women without visual signs of a tumor with high-grade squamous intraepithelial lesion (HSIL+) and cancer cells in the smears. Their study involved reexamination of ready cytology specimens and smears, expanded colposcopy, and a virological test for high-risk human papillomavirus (HPV) using chain polymerase reaction and hybrid capture 2 (HC2), as well as histological examination of biopsy and conization specimens during pregnancy and postpartum. Results. Out of 102 pregnant women, 43 (42.2%) were histologically found to have CIN1-2, koilocytosis; only 59 (57.8%) pregnant women with CIN3/CIS (n = 48) and MICUS without lymphovascular invasion (n = 11) were at risk for progression when carrying pregnancy to full term. Out of them, 58 patients decided to preserve pregnancy, 56 favorably carried it and gave birth to a full-term baby. Electrosurgical high-frequency conization was performed in 11 pregnant women in the second trimester and in all the patients 6-8 weeks after pregnancy termination. They fully recovered and had no disease progression. The patients are alive with no signs of incurability during follow-ups of 6 to 72 months. Conclusion. Cytological hyperdiagnosis of the degree of neoplasia is noted during pregnancy. Patents with CIN3/CIS and MICUS may carry pregnancy to full term with a favorable outcome in the fetus and the patient. Postpartum conization is sufficient to cure the majority of patients.

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作者简介

Lyubov Korolenkova

N.N. Blokhin Russian Cancer Research Center, Federal Agency of Research Organizations

Email: l.korolenkova@mail.ru
MD, senior researcher of the scientific advisory 115478, Russia, Moscow, Kashirskoye shosse 24

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