Clinicopathological Evaluation of Patients with SMILE, Cervical Intraepithelial Neoplasia 3, and Adenocarcinoma in Situ

Authors : Işık Sözen, Hilal Serap Arslan, Gözde Şahin, Yasemin Aboalhasan, Elif Dila Tasti, İlkbal Temel
Pages : 625-633
Doi:10.18663/tjcl.1788113
View : 51 | Download : 52
Publication Date : 2025-09-30
Article Type : Research Paper
Abstract :Aim: To compare cervical biopsy diagnoses with final surgical pathology results among patients with SMILE, CIN3, and AIS, and to evaluate differences in clinical-pathological features between these lesions. Methods: We performed a retrospective single-center analysis of patients diagnosed with SMILE (n=8), CIN3 (n=16), or AIS (n=14) who underwent surgical treatment. Clinical variables, high-risk HPV genotypes, cervical cytology findings, treatment modality, and pathological outcomes of surgical specimens were reviewed. Results: The distribution of HPV high-risk genotypes and cytologic diagnoses were similar between the groups (p>0.05). The rate of hysterectomy performed during initial treatment or after reoperation was higher in patients with AIS compared to the other groups. The concordance between the preliminary biopsy diagnosis and the pathological diagnosis after surgical excision differed significantly across lesion types (p<0.001). The need for a second surgical intervention was significantly more common in AIS and CIN3 cases than in SMILE cases (p=0.011). However, the final pathological results obtained in patients who underwent reoperation did not show a significant difference between the groups. Conclusion: Although the distribution of oncogenic HPV types and cytology findings were similar in SMILE, CIN3, and AIS, the agreement between biopsy and definitive surgical pathology was significantly different, highlighting diagnostic and management challenges especially for glandular lesions. The need for repeat surgical treatment was notably higher in AIS and CIN3 cases, underscoring the importance of thorough initial treatment and follow-up in these high-grade lesions.
Keywords : Servikal sitoloji, kolposkopi, biyopsi, uyum, servikal intraepitelyal neoplazi, Adenokarsinoma in situ, SMILE

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