Reevaluation of negative cone biopsy results after a positive cervical biopsy finding

This study aimed to evaluate and reexamine materials of the patients with cervical biopsy revealing cervical intraepithelial neoplasia and their cone biopsies revealing no lesion.

Twenty-five patients with cervical biopsy revealing cervical intraepithelial neoplasia and cone biopsies revealing no lesion among 202 patients who had undergone cervical conization after colposcopically derived cervical biopsy between 2005 and 2011 were included in this study. Ki67 and P16 were applied to the all biopsy slides. The conization blocks of patients whose reevaluation results of the original biopsy slides were positive were completely sectioned to reexamine the presence of any lesion, and suspicious areas were stained with Ki67 and P16.

Of the 25 patients' punch biopsies, no lesion was detected in 13 patients. The false positivity of first punch biopsy (52%) was the main reason for negative cone biopsy result after positive punch biopsy. Punch biopsies of the other 12 patients confirmed the lesions previously diagnosed. The detailed examination of conization specimens of the latter group showed 3 new low-grade cervical intraepithelial neoplasia, which had not been identified before.

Discordance between cervical biopsy findings and cervical conization findings could result from misdiagnosis of cervical biopsy, failure in preparation of the whole conization material, and technical difficulties of conization. Ki67 and P16 staining can be used in such cases to clarify the diagnosis.