[Comments on G. Waschke's article, efficacy of vaginal smear diagnosis and colposcopy in early detection of cervical carcinoma].
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CO2 laser vaporisation is an effective method in the treatment of cervico-vaginal pre-invasive lesions. In a case-series of 334 patients no case of invasive neoplasia development were registered at longterm follow-up. The failure rate is comparable to those described with traditional surgical methods and are due to the particular topography of the disease.
Cervical intraepithelial neoplasia remains a significant problem with regard to diagnosis and treatment. The emphasis has now shifted toward selection for treatment, partly as a result of an improved understanding of risk and partly as a result of simple excisional methods of treatment with low morbidity. It is now apparent that diagnoses based on small directed biopsy specimens may be misleading and whole transformation zone specimens should be regarded as the ideal. Although the role of oncogenic human papillomaviruses still remains obscure with regard to the etiology of cervical intraepithelial neoplasia, continued investigation is essential and rewarding in terms of an improved understanding of the molecular biology of malignant transformation and the interaction of transformed cells with the host's immune system.
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