Comparison of the grade of CIN in colposcopically directed biopsies with that in outpatient loop electrosurgical excision procedure (LEEP) specimens--a retrospective review.

BACKGROUND

It has been suggested that LEEP should be the standard for the diagnosis of cervical dysplasia, rather than colposcopically directed biopsy as traditionally so, since it is both diagnostic and therapeutic.

PATIENTS

Seventy-eight patients who underwent LEEP at the Gynaecological Cancer Centre, KK Hospital from 1 January 1995 to 31 December 1997 for cervical dysplasia diagnosed by colposcopically directed biopsy were retrospectively reviewed. The mean age of the patients was 40.3 years (SD 8.4), with 78.2% of them with CIN I or CIN II. The mean operating time was 11.8 minutes (SD 4.9) and 53.8% (42/78) were given prophylactic antibiotics, with the only complication being moderate postoperative haemorrhage in 3.8% (3/78). The mean follow-up period was 19.1 months (SD 9.3) with the cure rate being 97.4% (76/78).

RESULTS

Only half of the patients had corresponding histologies on biopsy and LEEP, with 28.2% (22/78) undergraded and 21.8% (17/78) overgraded.

CONCLUSION

Significant discrepancies may be found between the results of colposcopically directed biopsy and loop excision, and LEEP, which is safe and effective may be the choice procedure for the diagnosis of cervical dysplasia.