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Master thesis

Evaluation de la prise en charge des dysplasies cervicales chez 396 patientes traitées par conisation

Abstract : Faced with the rejuvenation of patients treated for intraepithelial neoplasia therapeutic decision problems arise. The aim of the study was to analyze the diagnostic value of cytology, colposcopy and histology preconization for high grade intraepithelial neoplasia, and the interest diagnosis of p18INK4a protein inhistochemistry. This consisted of a retrospective study of 396 patients who underwent conization at the Regional Maternity of Nancy from 1 January 2007 to 31 December 2009. The data collection regarding the history of the patients, the cytology, colposcopic, virological and histological with immunolabeling of p16INK4a results, before conization, and the long-term monitoring. They were compared with histologic findings on definite parts of conization. This work allowed to mount a significant relationship between abnormalities of high grade dysplasia in cone biopsy and Pap HSIL (p <0.001), a TAG2 to colposcopy (p = 0.0048), a CIN 2 or 3 at biopsy (p <0.001), a marking p16INK4a positive (p = 0.004). The kappa coefficient of concordance between the histological samples at biopsies and cervical conization was 0.4378. In the subgroup of patients with positive staining for p16INK4a, this coefficient was 0.3613. We found at followup 3.11% of stenosis and 11.11% of recurrence without statistical relationship with the histological results in the cone biopsy, or with the technique used. These results confirmed the strong correlation of cytocolpo- histology but with a significant disparity for CIN2, without significant improvement in the diagnostic concordance with the protein p16INK4a. Content risk of obstetric complications, it is essentialto restrict the treatment of cervical lesions to those in evolutionary potential. Biomarkers such as p16INK4a protein can help in this selection, but improvements are needed.
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Master thesis
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Submitted on : Wednesday, March 14, 2018 - 3:40:01 PM
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  • HAL Id : hal-01733198, version 1


Dalila El Bahja. Evaluation de la prise en charge des dysplasies cervicales chez 396 patientes traitées par conisation. Sciences du Vivant [q-bio]. 2011. ⟨hal-01733198⟩



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