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| Application value of colposcope biopsy and with loop electrosurgical excision procedure in the diagnosis and treatment of cervical lesions |
| LIU Ming |
| Department of Gynecology, Affiliated Hospital of Qingdao University, Shandong Province, Qingdao 266000, China |
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Abstract Objective To explore the value of cervical biopsy combined loop electrosurgical excision procedure (LEEP) in the diagnosis and treatment of cervical lesions. Methods Clinical data of 159 patients diagnosed by cervical biopsy under colposcope because of abnormal cervical TCT and/or HPV detection and volunteered for cervical ring electrotomy (LEEP) in Affiliated Hospital of Qingdao University from January 2016 to May 2017 were retrospectively analyzed, the results of and pathological examination after LEEP operation and diagnose accordance rate were observed. Meanwhile, the efficacy of LEEP in patients with cervical lesions was observed. Results Among 159 patients, there were 2, 4, 60, 59 patients were diagnosed as chronic cervicitis, condyloma, cervical intraepithelial neoplasia (CIN) Ⅰ, CIN Ⅱ/CIN Ⅲ both by cervical biopsy under colposcope and pathological examination after LEEP surgery respectively, 4 patients were diagnosed as cervical carcinoma in situ by pathological examination after LEEP surgery, and the coincidence rate was 78.62%. Among 4 cases of chronic cervicitis, there were 2 cases were pathologically up to CIN Ⅰ; among 11 patients with condyloma, 5 patients were pathologically up to CIN Ⅰ, 2 cases pathologically up to the CIN Ⅱ/CIN Ⅲ; among 76 patients of CIN Ⅰ, 11 cases were pathologically up to CIN Ⅱ/CIN Ⅲ, 5 cases down to cervicitis; among 68 patients of CIN Ⅱ/CIN Ⅲ, 2 cases were pathologically up to cervical carcinoma in situ, 7 cases were pathologically down to CIN Ⅰ. The consistency in the diagnosis of cervical lesions between cervical biopsy and LEEP was 0.632, with a high consistency. All patients successfully completed LEEP surgery, with an average operative time (27.50±5.03) min and an average intraoperative blood loss (31.75±8.29) mL. Except for 4 cases of cervical cancer patients diagnosed by LEEP postoperative pathological, 155 patients were all implement regular follow-up, follow-up time was 12-28 months, TCT examination results 6 months after operation showed that 155 patients without CIN, the cure rate was 97.48%, 2 patients were diagnosed as CIN Ⅱ again 1 year after operation. Conclusion Cervical biopsy under colposcope and histopathological examination after LEEP surgery are effective methods for the diagnosis of CIN and early cervical cancer, with a high consistency of two methods. The LEEP surgery can further lower the missed diagnosis rate of the high grade of CIN and cervical cancer, which is worthy of clinical application.
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