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Predictive factors for positive or negative pathology in loop and laser conizations
1*Department of Gynecology, Hôtel-Dieu Hospital †Department of Mathematics and Statistics, University of Montréal, Montréal, Québec, Canada.
Objective:
The main purpose of this study is to predict positive-negative pathology in association with operative indications in laser and loop conizations.
Materials And Methods:
This retrospective study comprises two groups of women, the first group composed of 74 loop conizations, the second of 78 laser cones. Positive endocervical curettage, unsatisfactory colposcopy with no visible lesion or junction, discrepant cytology and biopsy, suspicion of invasion, or a glandular lesion were considered as indications for cones. All cones were performed under local intramucous anesthesia, and 15 mm of endocervical mucosa was removed.
Results:
Loop and laser cone outcomes were comparable for age, parity, and pathology with negative or positive margins. Endocervical curettage of lesions of cervical intraepithelial neoplasia grades 2 and 3 (CIN2 and CIN3) predicted both higher cone pathology (p =.048) and high-grade squamous intraepithelial lesions, as evidenced by preoperative cytology (p =.000). Among 32 negative-margins cases, 2 (6.3%) had CIN persistence as compared to 6 patients (24%) of 25 positive margins.
Conclusions:
Laser and loop cones yield similar pathological results, and special care should be used for CIN1 endocervical curettage and low-grade squamous intraepithelial lesion cytology with conization indication, in regard to the high possibility of negative cone pathology.
