Evaluation of the Factors Affecting the Cure Rate of Cervical Intra-Epithelial Neoplasia Recurrence Using Defective Models

Background: Treatment of cervical intraepithelial neoplasia is very important since if it remainsuntreated, it may progress to cervical cancer. It is usually treated with excisional surgery. This studyaimed to find the factors affecting the cure rate of cervical intraepithelial neoplasia recurrence aftersurgery using defective models.Study design: A retrospective cohort study.Methods: Excisional surgery was performed on ۳۰۷ patients with high-grade cervical intraepithelialneoplasia, from ۲۰۰۹ to ۲۰۱۷. The patients were followed up until recurrence based onhistopathology report. Hematologic factors were measured before surgery. The cure rates wereestimated using defective models with a Gamma frailty term and the results were compared.Results: Neutrophil-to-lymphocyte ratio (NLR) (P<۰.۰۰۱) and excised mass size (P<۰.۰۰۱) hadsignificant impacts on cure rates, and their cut-off values were ۱.۹ (P<۰.۰۰۱) and ۱۵ mm۲(P<۰.۰۰۱), respectively. Patients with lower neutrophil-to-lymphocyte ratios and larger excisedtissues had higher cure rates. Defective ۳-parameter Gompertz distribution with gamma frailty termhad the best fit to the data, and its estimated cure rates were ۹۸% among patients with an excisedmass size of >۱۵ mm۲ and NLR of <۱.۹, ۸۴% among patients with an excised mass size of >۱۵mm۲ and NLR of >۱.۹, ۷۹% among patients with an excised mass size of <۱۵ mm۲ and NLR of<۱.۹, and ۳۰% among patients with an excised mass size of <۱۵ mm۲ and NLR of >۱.۹.Conclusion: Cervical intraepithelial neoplasia must be identified and treated before its progress.Excision of more tissues during excisional surgery, especially when the NLR of the patient is high,can help to prevent cervical intraepithelial neoplasia recurrence.

کلیدواژه ها:

Cervical intra-epithelial neoplasia ، Cure rate ، Defective models ، Survival analysis