{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T22:23:26Z","timestamp":1748125406406},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,9,6]],"date-time":"2018-09-06T00:00:00Z","timestamp":1536192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the features of skip lesions and evaluate value of top\u2010hat procedure in management of squamous intraepithelial lesion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the records of patients who underwent loop electrosurgical excision procedure (LEEP) in Peking University First Hospital between 2011 and 2016. Patients were confirmed to have CIN1\u20133. The term \u2018skip lesion\u2019 refers to lesion lying deep in cervical canal discontiguous with other lesions in transformation zone and was confirmed by top\u2010hat. We compared their lesion grade in patients with or without skip lesion using logistic regression. We further reviewed patients who underwent subsequent hysterectomy within 6\u2009months following LEEP and evaluated if top\u2010hat procedure led to less residual lesions or was able to predict residual lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2260 patients were included and 595 underwent top\u2010hat procedure. Thirty\u2010nine out of 595 patients had skip lesions (6.5%), among whom two patients had CIN1 (5.1%), eight had CIN2 (20.5%) and 29 had CIN3 (74.4%). Logistical regression showed CIN3 was associated with higher risk of skip lesions compared to CIN1 (OR\u2009=\u20094.433, 95%CI: 1.036\u201318.964), while CIN2 was not (OR\u2009=\u20091.762, 95%CI: 0.366\u20138.471). Sixty\u2010two patients underwent hysterectomy within 6\u2009months following LEEP (CIN1\u20133), 24 underwent top\u2010hat. Analysis revealed top\u2010hat procedure did not result in less residual lesions. Colposcopy impression or prior HPV test was unable to predict skip lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>About 9.4% patients with CIN3 had skip lesions in the study, which is associated with elevated risk for residual lesion. Top\u2010hat procedure is able to detect skip lesions, but should not be performed on routinely because its prognostic value is not proved.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.13781","type":"journal-article","created":{"date-parts":[[2018,9,7]],"date-time":"2018-09-07T01:55:36Z","timestamp":1536285336000},"page":"182-188","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Value of top\u2010hat procedure in management of squamous intraepithelial lesion"],"prefix":"10.1111","volume":"45","author":[{"given":"Fangda","family":"Leng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Nong","sequence":"additional","affiliation":[{"name":"Department of Pathology Peking University First Hospital  Beijing 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