Accuracy of colposcopically directed biopsy in patients with cervical neoplasia

The histologic diagnoses of premalignant and malignant lesions of the cervix obtained by examining the colposcopically directed biopsy material from 643 patients were compared with those of the surgical material subsequently obtained. The procedures during which samples were acquired included hysterectomy (370), cervical conization (263), cervical amputation (2), and removal of a retained cervical stump (8). The diagnostic accuracy of colposcopically directed biopsy was 93.0% in those patients with satisfactory colposcopy, ie, the final diagnosis did not differ by more than 1 grade from that of the directed biopsy diagnosis. Two patients with widespread stage III cervical intraepithelial neoplasia on directed biopsy had microinvasive carcinoma in the therapeutic cone specimen. All invasive carcinomas (stage IB, occult) were diagnosed by directed biopsy and confirmed by subsequent examination of the surgical specimen.