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A "See and Treat" approach for high grade squamous intraepithelial lesion on cervical cytology
Kittipat Charoenkwan1, Jatupol Srisomboon, Sumalee Siriaunkgul
1Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand. kicharoe@med.cmu.ac.th
Objective:
To examine the final histologic findings as well as to correlate colposcopic and histologic findings in patients who had a high-grade squamous intraepithelial lesion (HGSIL) on the Pap smear and underwent colposcopy followed by LEEP on the "See and Treat" basis without intervening colposcopically directed biopsy.
Material And Method:
The medical records of patients with HGSIL on cytology who underwent LEEP without prior cervical biopsy at Chiang Mai University Hospital over a 5-month period were reviewed. The authors summarized the final LEEP histologic results and correlated colposcopic and histologic findings in these patients.
Results:
Of 55 patients who had a see-and-treat LEEP, 53 patients (96%) had a high-grade intraepithelial lesion or higher. There were 11 patients (20%) who had invasive squamous cell carcinoma. Of 4 patients with a low-grade lesion on colposcopic examination, all had a high-grade lesion or higher on final histology. Forty-four patients (96%) with high-grade impression on colposcopy had high-grade or more severe lesion on the final histologic diagnosis.
Conclusion:
For patients with a high-grade lesion on the Pap smear, LEEP according to the "See and Treat" approach appeared to be a reasonable alternative to conventional colposcopically directed biopsy, especially in low resource settings.
