Predictors of Negative Cone Biopsies and Its Clinical Significance

Abstract

Objective: To determine the predictors of absence of lesion on cone biopsy (white cone). We evaluated several factors including parity, cytology, human papillomavirus (HPV) typing, biopsy, colposcopy, smoking habit, use of oral contraceptive or condom, and immunosuppression as predictors for absence of dysplasia. Methods: Of 510 patients with CIN (cervical intraepithelial neoplasia) treated by loop electrosurgical excision (LEEP) in the Fundación Jimenez Diaz hospital between 2012 and 2016, 51 (10%) patients had a white cone and were defined as the study group. The control group was established from two randomly selected controls for each case (n = 102). Results: The study group had a higher prevalence of low-grade cytology (p < 0.001), minor changes (p < 0.01), and CIN 2 (<0.001) than the control group. The study group had a lower rate of oral contraceptive use (p = 0.005), as demonstrated by the multivariate analysis (except for low-grade cytology). Conclusions: In conclusion, this study indicates that the incidence of white cone in our institution is 10% of all the cone biopsy and women with low-risk cytology, minor changes in colposcopy, CIN 2, and no use of oral contraceptive have a high probability of having no lesions in the conization specimen.