High-grade cervical intraepithelial neoplasia, human papillomavirus and factors connected with recurrence following surgical treatment

Abstract

Although effective strategies for preventing cancer of the uterine cervix exist, this disease continues to be a serious health problem worldwide, especially in developing countries. Today, the role of human papillomavirus (HPV) as a causal factor for the emergence of cervical cancer and its precursor lesions is well established, and prevention programs against cervical cancer are based on detecting cervical intraepithelial neoplasia (CIN). HPV present immunological evasion mechanisms that inhibit detection of the virus by the host, which may result in persistent chronic infection and irrevocably comprise the host defenses. Conization is the surgical technique most used for treating high-grade CIN, since it makes it possible to exclude invasive neoplasia, evaluate resection margins and preserve fertility. However, several factors have been considered to be indicators for residual disease. This review had the aim of covering some factors relating to persistence and recurrence of high-grade CIN following conization.