Study for Early Cervical Neoplasia Confirmed by Cervical Cornization

Lee, H B; Kang, J B; Kim, H B; Lee, K Y; Kang, S W

Abstract

OBJECTIVE: To investigate the accuracy rates of cytology, punch biopsy in early cervical neoplasms, including severe dysplasia, carcinoma in situ, microinvasive carcinoma confirmed by conization. STUDY DESIGN: During the 5 years from 1991 to 1995 conization was performed on 103 patients and then 62 patients early cervical neoplasia was proven by conization at the Gynecologic oncologic department of the Hallym University Kangnam Sacred Heart Hospital. We performed cytologic test with cytobrush, 4-quardrent punch biopsy, electrosurgical diathermy or LLETZ. Retrospectively chart review, The accuracy of cytology, punch biopsy, conization were investigated.
RESULTS
The mean age was 44 years old(41 to 50 years old). Average gravida was about 2.5(0-7). The results of cytology were severe dysplasia & carcinoma in situ-66%(20/30), microinvasive cancer-26%(7/26), true invasive cancer-16% (1/6). The accuracy of cytology was 45% and underestimation rate was 51%. The result of punch biopsy were severe dysplasia & CIS-86%(26/30), microinvasive cancer-46%(12/26), invasive cancer-16%(1/6). The accuracy of punch bipsy was 63% and underestimattion rate was 37%. The final result were that severe dysplasia-8 cases, CIS-22 cases, microinvasive cancer-26 cases, true invasive cancer-6 cases. we observed complications of ionization that bleeding 5 cases(4.8%), infection 4 cases(3.9%), cervical stenosis 2 cases.(1.9%)
CONCLUSION
These results suggest that a composite diagnosis with cytology, punch biopsy is necessary for a correct evaluation. These results confirm the risk of over - looking invasive disease by conventional preconization evaluation. Management for early cervical neoplasia, we recommend conization as the best conservative procedure, and diagonostic method in preservation of reproductive function and management of patients with early cervical neoplasia of the cervix.