Conservative Management Outcome of Cervical Intraepithelial Neoplasia Grade 2: A Three-Year Follow-Up Study
Bibliographic record
Abstract
Background: This study aimed to evaluate the safety and outcomes associated with the conservative management of cervical intraepithelial neoplasia grade 2 (CIN2) in women by assessing the rates of spontaneous regression of CIN2, persistence of CIN2, or progression to CIN3 and cancer. Methods: We conducted a retrospective cohort study at DGH Hospital in the UK. We examined the medical records using the "Infoflex" system of 146 women with histologically confirmed CIN2 between April 1, 2019, and April 30, 2022. These patients underwent regular follow-ups every 6 months, including colposcopy, repeated cervical smears/punch biopsy, and human papillomavirus (HPV) testing to monitor the progression or regression of their cervical lesions. The analysis included assessing the rates of spontaneous regression of CIN2, progression to CIN3 and cancer, the duration of conservative management, and the number of patients who defaulted on follow-up. Results: Among the 146 women with histologically confirmed CIN2, only 67 patients were eligible for conservative management. All cases underwent thorough evaluation by a multidisciplinary team (MDT); and out of these 67 cases, nine cases were upgraded after MDT review: six based on histological findings (punch biopsies) from CIN2 to CIN3, and three based on upgraded cytological assessments resulting in a total of 56 cases suitable for CIN2 management. Out of these 56 women; 39 women were in the age group between 25 and 30 years; 15 women between 30 and 35 age group; one patient was 36 years, and one patient was 40 years old. Regression rate was 71% (n = 40/56) with conservative management; two cases progressed to CIN3 (had large loop excision of the transformation zone (LLETZ) procedure) with no progression to cancer. At 6, 12, 18, and 24 months, the number of negative smears were 27/56 (48%), 5/56 (8.9%), 2/56 (3.5%), and 1/56 (1.7%), respectively. Conclusions: Contrary to prior studies (upper age limit < 30 years), our findings support successful (71% regression rate) conservative management (CIN2) in women aged 25 - 40 years. Additionally, our observations highlight the quicker resolution of cytological abnormalities compared to histological regression. J Clin Gynecol Obstet. 2024;13(1):8-11 doi: https://doi.org/10.14740/jcgo936
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".