The Correlation between Colposcopically Directed Cervical Biopsy and Loop Electrosurgical Excision Procedure Pathology and the Effect of Time on That Agreement

Barker, Bel; García, Francisco; Lozevski, Jonathan; Warner, J O; Hatch, Kenneth D.

doi:10.1006/gyno.2001.6245

Cited by 33 publications

(35 citation statements)

References 4 publications

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“…In our study, the agreement between biopsy findings and the final histological results after conization was 85.5 % which is significantly higher than the correlation reported in other studies [3,[5][6][7][8][9]. 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.…”

contrasting

confidence: 81%

“…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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contrasting

confidence: 81%

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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“…At our 10 year experiences, the rate of conization was 56.7%. Most previous reports of the accuracy of colposcopically directed biopsy versus cone histology diagnosis have been descriptive eval- uations [12,13], or were concerned with the calculation of perfect agreement [14,15], or agreement to within one degree [8], or both procedure were done at the same time prospectively [16]. In fact, the actual clinical signifi cance of biopsy errors varies greatly.…”

Section: Discussionmentioning

confidence: 99%

“…Our rate of unconfi rmed high-estimated CIN biopsies 5.8% (6/104). A negative diagnosis on cone specimen may be caused by infl ammation and wound healing processes induced by biopsy [8,14], removal of the entire lesion [12,15], spontaneous regression between biopsy and conization [12,21], failure to include the involved area in the cone excision specimen [21,22], laboratory errors in cone handling and processing [23], and variability in histopathological diagnosis [12] and grading of CIN [24]. In principle, these factors may account for our own cases.…”

Section: Discussionmentioning

confidence: 99%

“…This is especially the case for the determinants of the probability of a carcinoma remaining undiagnosed. Most previous studies were based on small series of CIN biopsies and, while inherently unacceptable, the prevalence of missed microinvasive or invasive carcinoma was generally less than 5% with a mean of 1.8% [8,9]. We collected the clinical data of the patients whose punch biopsy results were CIN 3 and tried to correlate the histology diagnosis of biopsy with that of the surgical specimen in our institution.…”

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confidence: 99%

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The Correlation of cervical intraepithelial neoplasia 3 detected by cervical punch biopsies with the pathologic results of conization and hysterectomy

Kim

Park

et al. 2011

Korean J Obstet Gynecol

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ObjectiveTo know the correlation of punch-biopsy proven cervical intraepithelial neoplasia (CIN) 3 with the results of cone and hysterectomy. MethodsWe reviewed the medical records from 1999 to 2008, retrospectively, at a single institution. We checked age, cone and hysterectomy biopsy results, preoperative cervical smear results as well as human papillomavirus results. ResultsThere were 104 patients whose punch biopsy results were CIN 3. 59 (56.7%) patients underwent cone and 45 did hysterectomy after punch biopsies. Cone found 6.8% of cervical cancer. Among patients undergoing hysterectomy without cone, 8.9% had cervical cancers. There were a lot of inflammations, atypical squamous cells of unknown significance, low-grade squamous intraepithelial lesion done as a Pap results just before cone. The positive rate of HPV was 80.0%. There were 5.1% of underestimated and 6.8% of over-estimated results according to the cone results, and 6.7% of under-estimated and 8.9% of overestimated according to the hysterectomy results. ConclusionThrough conization, 93.2% of the patients whose punch biopsy results were CIN 3 had CIN and did not need hysterectomy, and 6.8% had cervical cancers and might need further treatment. Through hysterectomy, 91.2% had CIN and might undergo overtreatment. Limited accuracy of punch biopsy of the cervix in defi ning extent and severity of epithelial lesions in women presenting with abnormal Pap smear remains an important clinical problem. Studies correlating the histology diagnosis of biopsy with that of the surgical specimen showed both under-and over-estimations. Biopsy diagnoses that overestimate the grade of cervical intraepithelial neoplasia (CIN) are associated primarily with potential overtreatment. Albeit less frequent, underestimations may have even more serious implications. The greatest concern is that early invasive lesions may be missed and inadvertently treated by an ablative technique [1,2]. Disease relapse in such patients has been described [3]. The

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Quality assurance in cervical screening of a high risk population: A study of 65,753 reviewed cases in Parana screening program, Brazil

et al. 2005

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Epidemiological data from the Quality Assurance Unit (QAU) of the Cervical Cancer Screening Program of Paraná is discussed. Slides (65,753) reviewed by the QAU, from October 1997 to July 1999, were analyzed. Relations between agreement rate, diagnostic categories, and age groups were tested. The overall agreement rate was 97.04% (kappa +/- 95%, confidence interval = 0.888 +/- 0.003). Low-grade squamous intraepithelial lesion (LSIL) showed its peak prevalence in patients < or = 19 yr (8.3%). High-grade squamous intraepithelial lesion (HSIL) was more common in women between 40 and 49 yr (5.0%). Squamous-cell carcinoma (SCC) was almost exclusively seen in women > or = 40 yr. The lowest agreement rates were seen in adenocarcinoma (54.5%; kappa = 0.667) and LSIL cases (76.3%, kappa = 0.822), and in women < or = 19 yr (95.8%). It was concluded that constant monitoring to assess specific errors allows directed measures. The 10% rescreening model of quality assurance proved to be effective in a low resources setting with a positive overall financial impact.

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The Correlation between Colposcopically Directed Cervical Biopsy and Loop Electrosurgical Excision Procedure Pathology and the Effect of Time on That Agreement

Cited by 33 publications

References 4 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

The Correlation of cervical intraepithelial neoplasia 3 detected by cervical punch biopsies with the pathologic results of conization and hysterectomy

Quality assurance in cervical screening of a high risk population: A study of 65,753 reviewed cases in Parana screening program, Brazil

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