The Repair Process of the Uterine Cervix Subjected to CO2 Laser Vaporization: A Pilot Study

Objective: Cervical intraepithelial neoplasia (CIN) frequently affects young women in childbearing age. Present literature does not provide scientific consensus on the real incidence of obstetric complications after the various conservative techniques performed. Most of all literature data are still lacking a pathophysiological basis to explain the different impact of various treatment techniques on the functional integrity of the uterine cervix. The gold standard conservative treatment is the excisional therapy. This study tried to analyze the evolution of tissue repair of cervix subjected to CO2 laser conization for high grade CIN with the aim of identifying eventual differences between the repaired tissue and the original cervical one. Study Design: The analysis was conducted on histological seriated samples of uterine cervix obtained at standardized times after conization treatments and then analyzed using histological examination and immunohistochemical staining. Results: This study showed that the tissue concentration of TGFβ1 was significantly low in patients treated with CO2 laser, confirming the reduced inflammatory reaction after laser treatment. Another very interesting result was the high ratio of type III and type I collagen: the prevalence of type III collagen suggested a regeneration of tissue without scarring after laser therapy. Conclusion: Tissue repair process after CO2 laser cervical treatment is able to compensate the loss of substance in damaged area and at the same time to limit the deposition of disorganized connective matrix, typical of scars, leading to a morphologic and functional restitutio ad integrum of the treated cervical tissue, which tends to be similar to the original one.