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Negative cone biopsies after colposcopy and their prediction
D M Luesley1, T Wade-Evans, J A Jordan
1Dudley Road Hospital, Birmingham.
British Journal of Obstetrics and Gynaecology
|September 1, 1987
Summary
Prior colposcopic assessment reduces unnecessary cone biopsies. Five key variables predict dysplastic or neoplastic tissue, potentially avoiding 44% of negative cone biopsies without missing microcarcinomas or occult carcinomas.
Area of Science:
- Gynecologic Oncology
- Cervical Pathology
Background:
- Cone biopsies are used to diagnose cervical abnormalities.
- Not all cone biopsies reveal significant pathology, leading to unnecessary procedures.
Purpose of the Study:
- To identify predictors of dysplastic or neoplastic tissue in cone biopsy specimens.
- To determine if these predictors can reduce the rate of negative cone biopsies.
Main Methods:
- Retrospective analysis of 899 cone biopsies.
- Case-control study of 'negative', CIN, microcarcinoma, and occult carcinoma cones.
- Identification of five predictive variables for abnormal tissue.
Main Results:
- Prior colposcopic assessment was associated with fewer negative cone biopsies.
- Five variables identified: colposcopic suspicion of invasion, positive/worse pre-cone smear, two severe dyskaryotic smears in 12 months, prior abnormal histology, and prior CIN treatment.
- Applying these criteria could avoid 44% of negative cone biopsies without missing significant disease.
Conclusions:
- Predictive criteria can help select patients for cone biopsy.
- This approach may reduce unnecessary procedures and healthcare costs.
- Further validation of these criteria is warranted.