The Role of Cold Knife Conization in Cervical Neoplasia

Ko, Sun Hee; An, Tae Sun; Jang, Suk Hyun; Jang, Jun Hyuk; Weon, Jong Cheon; Jung, Kang Woo; Kim, Yong Pil

Abstract

OBJECTIVE
The purpose of this study is to evaluate the role of cold knife conization in the diagnosis and treatment of cervical neoplasia.
METHODS
Sixty patients were divided into diagnostic and therapeutic conization group and then indication of conization, PAP smear, colposcopy directed biopsy, cone margin and residual lesion of each group were compared respectively.
RESULTS
If the difference of PAP and colposcopy directed biopsy was 2 grades or more, upper limit of the lesion was invisible, squamocolumnar junction was not seen, PAP V or invasive cancer was suspected, diagnostic conization was performed in 22 patients. Six cases of follow-up group had cone margin (-) and no recurrence. Sixteen cases of immediate TAH (total abdominal hysterectomy) group had 2 cases of cone margin (+) with residual disease. There were 4 cases of cone margin (-) with residual lesion. If the difference of PAP and colposcopy directed biopsy was 1 grade or less, upper limit of the lesion was visible, squamocolumnar junction was seen and invasive cancer was ruled out, therapeutic conization was performed in 38 cases. All of therapeutic conization group had cone margin (-). Thirty two cases were follow up group and six cases were immediate TAH group. Three of follow up group had recurrences and delayed TAH was performed. There was no residual lesion in the specimen of immediate TAH group.
CONCLUSION
The precise dignosis and treatment of cervical neoplasia was capable with cold knife conization. The more aggressive lesion or the more cases of cone margin (+) was diagnosed, the more residual lesion was found. Thorough follow up should be done after treatment of cervical neoplasia because of the possibility of residual disease even after documentation of cone margin (-).