June 6th, 2020

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Observation of a Robust Immune Inflammatory Response Following Frictional Fabric Cervical Biopsy and Endocervical Curettage During Colposcopy
Authors:  Arthur Sitelman, M.D., Justin Diedrich, M.D., M.S.C.I., and Neal M. Lonky, M.D., M.P.H.
  OBJECTIVE: To investigate if fabric-based frictionalbiopsy sampling showed anatomic pathological evidence of a subsequent persistent immune inflammatory cellular response and, if so, the duration of this effect.

STUDY DESIGN: This is a retrospective case series review of historical and anatomic pathological evidence of the presence of an inflammatory immune reaction in cases that underwent colposcopic frictional brush ectocervical and endocervical biopsy followed by therapeutic large loop electrosurgical excision of the transformation zone (LLETZ).
RESULTS: Fourteen cases in which colposcopic biopsies were followed by a LLETZ excision were reviewed, yielding 12 cases with complete documentation. Six of 7 cases in which LLETZ followed colposcopy within 30 days showed evidence of a persistent robust inflammatory immune response under the biopsy sites, which dissipated after 30 days in the 5 remaining cases.

CONCLUSION: Debonding of cervical epithelium and superficial stroma using frictional brushes yields diagnostic biopsy specimens and shows persistent anatomic evidence of an immune response at the surgical site. The immunogenicity and therapeutic benefit deserves future studies of cell mediated and humoral response associated with longitudinal regression of cervical neoplasia.
Keywords:  biopsy, cervical dysplasia, cervical intraepithelial neoplasia, cervix, colposcopy, curettage, HPV, human papillomavirus, immune, loopexcision, uterine cervical neoplasms
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