The histologic reliability of laser cone biopsy of the cervix

Howell, Rosemary; Hammond, Rob; Pryse‐Davies, J.

doi:10.1016/0020-7292(92)90063-o

Cited by 16 publications

(15 citation statements)

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“…1,4,23 Other changes include separation of the epithelial layer from the underlying stroma, elongation of the nuclei and nuclear hyperchromatism. 7,14 Several investigators have found that artifact can be minimized by making fewer cuts during the procedure (resulting in a specimen with as few pieces as possible, ideally in a single piece). 14,17 The amount of thermal artifact can also reduced by having an highly experienced operator perform the LEEP procedure.…”

Section: Discussionmentioning

confidence: 99%

The Case for Cytologic Follow-up After LEEP

Hanau

Bibbo²

1997

Acta Cytologica

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Section: Discussionmentioning

confidence: 99%

The Case for Cytologic Follow-up After LEEP

Hanau

Bibbo²

1997

Acta Cytologica

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“…In these cases, the patients have generally been satisfied with the safety of nothing being overlooked. 69,70 The results demonstrate the need for excisional management, rather than local destructive therapy, in patients with demonstrated CIN. Otherwise, an unacceptably high frequency of invasive disease would be missed, and the treatment could be hazardous, delaying proper diagnosis and sufficient treatment.…”

Section: Reliability Of Preconization Diagnostic Evaluationmentioning

confidence: 88%

Laser Conization in the Management of Cervical Intraepithelial Neoplasia and Microinvasive Carcinoma of the Uterine Cervix

Andersen¹

2000

Journal of Gynecologic Surgery

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This review article evaluates laser conization as a method to diagnose and treat cervical intraepithelial and microinvasive carcinoma of the cervix, including simple excisional conization and combination conization.Laser conization, when performed by competent surgeons with state-of-the art equipment, is equal or superior to knife cone or Lietz cone. As with other conization procedures, the risk of preterm delivery increases with the volume and height of the cone. Laser conization height should never exceed 20 minutes (J GYNECOL SURG, 16:1, 2000)

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“…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%

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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The histologic reliability of laser cone biopsy of the cervix

Cited by 16 publications

References 0 publications

The Case for Cytologic Follow-up After LEEP

The Case for Cytologic Follow-up After LEEP

Laser Conization in the Management of Cervical Intraepithelial Neoplasia and Microinvasive Carcinoma of the Uterine Cervix

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

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