Assessment of cervical intraepithelial neoplasia (CIN) with colposcopic biopsy and efficacy of loop electrosurgical excision procedure (LEEP)

Duesing, Nina; Schwarz, J.; Choschzick, Matthias; Jaenicke, Fritz; Gieseking, Friederike; Issa, Rana; Mahner, Sven; Woelber, Linn

doi:10.1007/s00404-012-2493-1

Cited by 86 publications

(73 citation statements)

References 21 publications

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“…Those studies predominantly recorded whether there was a precise agreement between biopsy and conization results; they might have reported a higher correlation if overestimated results had been grouped together with precise agreement. The results of another German study were very similar to ours (85.8 %) with regard to histological agreement [10]. Baldauf et al also reported a very high agreement (89.6 %) between biopsy and conization results (overestimation 4.6%) [11].…”

supporting

confidence: 86%

“…Studies have reported complete agreement in between 45 and 89.6 % of cases. Agreement within one histological grade was present in between 74 and 89.9 % of cases [5][6][7][8][9][10][11]. The crucial issue is to determine which conditions and factors can influence the accuracy of biopsy findings.…”

Section: Accuracy Of Colposcopically Guided Diagnostic Methods For Thmentioning

confidence: 99%

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Accuracy of Colposcopically Guided Diagnostic Methods for the Detection of Cervical Intraepithelial Neoplasia

Müller

Soergel

Hillemanns

et al. 2016

Geburtshilfe Frauenheilkd

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!Introduction: Many factors can affect the accuracy of colposcopically guided biopsy, endocervical curettage (ECC) and differential cytology, all of which are standard, minimally invasive procedures used to detect cervical intraepithelial neoplasia. Method: All conizations carried out between 2007 and 2013 in the gynecological department of Hannover Medical School were retrospectively reviewed. The agreement between colposcopic diagnosis and histology was evaluated retrospectively. The analysis included 593 complete datasets out of a total of 717 cases treated. Results: The overall agreement was 85.5 %; the accuracy was significantly higher (p = 0.029) when three biopsy specimens were taken rather than just one. The agreement between diagnosis and histological findings from conization was highest for women < 30 years (90.7%) and lowest for women > 50 years (72.1%; p = 0.008). The agreement between preoperative differential cytology and histology results after conization was 86.7 % and improved as patient age increased (p = 0.035). The agreement between ECC findings and the results of conization was only 49.1 % irrespective of patient age, transformation zone or the patientʼs menopausal status. Conclusion: The accuracy of colposcopically guided biopsy appears to increase when three biopsy specimens are taken and is particularly high for younger patients. Differential cytology was also found to be highly accurate and is particularly useful for patients aged more than 50 years. The accuracy of ECC was significantly lower; however ECC can provide important additional information in selected cases.

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supporting

confidence: 86%

Section: Accuracy Of Colposcopically Guided Diagnostic Methods For Thmentioning

confidence: 99%

Accuracy of Colposcopically Guided Diagnostic Methods for the Detection of Cervical Intraepithelial Neoplasia

Müller

Soergel

Hillemanns

et al. 2016

Geburtshilfe Frauenheilkd

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“…They concluded that CDB is an accurate method. The concordance rate was higher for CIN2/3 (95.1%) when compared with CIN1 (63.2%) (Duesing et al, 2012). We did not perform the excisional procedure (LEEP) for all of the CIN 1 cases; so concordance rate between CDB and LEEP was not evaluated statistically in our study.…”

Section: Discussionmentioning

confidence: 80%

Is the Loop Electrosurgical Excision Procedure Necessary for Minor Cervical Cytological Abnormalities?

Guldeniz

Turkan²,

Murat³

2014

Asian Pacific Journal of Cancer Prevention

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Background: To investigate the indications of loop electrosurgical excision procedure (LEEP) and its overtreatment rates for the see and treat and three step strategies in cases of atypical squamous cells of undetermined cytology (ASC-US) and low grade intraepithelial neoplasia (LGSIL) cytology. Materials and Methods: We retrospectively analyzed colposcopy directed biopsy (CDB) and LEEP results of 176 paients with ASC-US or LGSIL cytologies who underwent colposcopic examination. Results: Initial cytologies were ASCUS in 120 women and LGSIL in 56. According to the see and treat approach immediate LEEP was performed for38 women. Among the remaining 138 women, LEEP was performed for 32 whose CDB results revealed CIN2/3 lesions. In the see and treat group the recognition of CIN2/3 was found to be 39.4%. The overtreatment rate was 60% as compared to 25% in the three step group. In CDB group detection of CIN 2 or greater lesions increased with 3 or more biopsies. Conclusions: In patients with ASC-US/LGSIL cytologies CDB should be performed before LEEP to prevent overtreatment, with attention to all suspected areas and more than 2 biopsies taken.

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“…In order to prevent abnormal cytology or CIN 3 recurrence, margin ablation is important, particularly in coin resection cases. Margin ablation is important in the prevention of recurrence after conization, and it is possible to reduce the follow-up visits after surgery in such cases (20,21).…”

Section: Cytological Findings After Treatment -----------------------mentioning

confidence: 99%

Clinical significance of atypical squamous cells of undetermined significance after treatment for cervical intraepithelial grade?3 neoplasia: A retrospective single‑center cohort study

et al. 2017

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Abstract. The aim of the present study was to evaluate the clinical significance of atypical squamous cells of undetermined significance (ASC-US) following cervical conization for cervical intraepithelial neoplasia (CIN) grade 3. This study was a retrospective cohort analysis. The medical records of women treated with conization for CIN 2-3 were reviewed and 142 patients with CIN 3 who had been diagnosed using the conization specimens were selected. The mean follow-up period after conization was 41.8 months. Cytological abnormalities after conization were observed in 19.0% of the patients and consisted of ASC-US (13.4%) and worse than low-grade squamous intraepithelial lesion (LSIL; 5.6%). Recurrence was defined as a diagnosis worse than CIN 2, and the recurrence rate was 29.6% among patients with abnormal cytology. The recurrence rate was 15.7% in the ASC-US group and 71.4% in the worse than LSIL group. There was no significant difference in the time of initial identification of abnormal cytology after treatment between the worse than LSIL and the ASC-US groups (P= 0.054). However, the ASC-US group had a significantly better cumulative recurrence-free rate compared with the worse than LSIL group (P<0.05). Women with ASC-US following treatment for CIN appear to be at a relatively high risk. Regarding the risk stratification of women following treatment for CIN, if surveillance cytology shows ASC-US, immediate colposcopy is recommended, along with long-term follow-up.

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Assessment of cervical intraepithelial neoplasia (CIN) with colposcopic biopsy and efficacy of loop electrosurgical excision procedure (LEEP)

Abstract: Assessment of cervical lesions with colposcopic biopsy is an accurate method (concordance with cone histology 85.8%). Surgical treatment of high grade CIN with LEEP is a safe procedure with low recurrence rates, resulting in a clearance of cervical HPV infection in the majority of cases.

Cited by 86 publications

References 21 publications

Accuracy of Colposcopically Guided Diagnostic Methods for the Detection of Cervical Intraepithelial Neoplasia

Accuracy of Colposcopically Guided Diagnostic Methods for the Detection of Cervical Intraepithelial Neoplasia

Is the Loop Electrosurgical Excision Procedure Necessary for Minor Cervical Cytological Abnormalities?

Clinical significance of atypical squamous cells of undetermined significance after treatment for cervical intraepithelial grade?3 neoplasia: A retrospective single‑center cohort study

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