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Related Experiment Videos

A LEEP cervical conization is rarely indicated for a two-step discrepancy.

Grainger S Lanneau1, Valerie Skaggs, Kathleen Moore

  • 1The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73169, USA. grainger-lanneau@ouhsc.edu

Journal of Lower Genital Tract Disease
|June 29, 2007
PubMed
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A loop electrocautery excision procedure (LEEP) cone is rarely needed for two-step discrepancies in cervical cancer screening. Further randomized trials are recommended to confirm these findings for cervical intraepithelial neoplasia (CIN).

Area of Science:

  • Gynecology
  • Oncology
  • Pathology

Background:

  • Cervical conization is indicated for two-step discrepancies between cytology and histology.
  • Loop electrocautery excision procedure (LEEP) is a common treatment for cervical dysplasia.

Purpose of the Study:

  • To determine the utility of a LEEP cone for evaluating two-step discrepancies between cervical cytology and histology.
  • To assess the diagnostic yield of LEEP in cases with discordant cervical findings.

Main Methods:

  • Retrospective chart review of women with a high-grade squamous intraepithelial lesion (HSIL) cytology and normal or CIN 1 biopsy.
  • Exclusion of CIN 2 cases; statistical analysis using SAS 9.
  • Focus on LEEP cone findings for discrepancies.

Related Experiment Videos

Main Results:

  • Of 59 patients, 27 underwent a LEEP cone. Among those with normal biopsy and HSIL cytology, 41% had CIN 3 on LEEP.
  • In patients with CIN 1 biopsy and HSIL cytology, 64% had CIN 3 on LEEP.
  • The second pass of the LEEP cone rarely identified CIN (4% of cases), indicating low utility.

Conclusions:

  • A LEEP cone is infrequently indicated for two-step discrepancies in cervical screening.
  • Randomized trials are needed to validate the role of LEEP cones in managing these discrepancies.