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Loop excision for high-grade squamous intraepithelial lesion on cytology: correlation with colposcopic and histologic
Dennis C Szurkus1, Terry A Harrison
1Division of Gynecologic Oncology, Naval Medical Center, PSC 1003 Box 8, San Diego FPO AE, CA 09728, USA.
Objective:
Our purpose was to examine the correlation between colposcopic and histologic findings in patients who have undergone loop electrosurgical excision of the cervix (LEEP) for high-grade dysplasia on cytology without prior colposcopically directed biopsy.
Study Design:
A retrospective review was performed of all patients who underwent LEEP for high-grade squamous intraepithelial lesion (HGSIL) on Papanicolaou (Pap) smear without a prior cervical biopsy over a 17-month period. We correlated the histologic result with colposcopic findings at the time of LEEP.
Results:
Of 104 patients undergoing LEEP, 63 patients (61%) had cervical intraepithelial neoplasia (CIN) grade 2 or greater. Thirty-four (54%) of these 63 patients with histologically proved high-grade dysplasia had a normal or low-grade colposcopic examination. There were 10 patients with CIN 1 to CIN 1-2 and 1 patient with microinvasive squamous cell carcinoma.
Conclusion:
Despite lack of correlation between colposcopic and histologic results, HGSIL on Pap smear is an appropriate indication for LEEP.