Efficacy of Loop Electrosurgical Excision Procedure (LEEP) in CIS (Carcinoma in Situ) of Uterine Cervix

Yoo, Hye Rhee; Park, Young Han; Kim, Sung Joo; Jang, Pong Rheem

Abstract

OBJECTIVE
The purpose of this retrospective study is to evaluate the efficacy of Loop Electrosurgical Excision Procedure (LEEP) in the diagnosis and in the treatment of CIS (carcinoma in situ).
METHODS
Between Jan. 1999 and Apr. 2000, 94 patients with CIS were treated in the Hallym University Sacred Heart Hospital. Three procedures were performed: cytology, punch biopsy and LEEP (loop electrosurgical excision procedure). And the results of cervical cytology, punch biopsy, phathologic diagnosis of LEEP specimens were evaluated in comparison with the pathologic diagnosis of hysterectomy specimens.
RESULTS
Followings are results summarized. 1. The concordance rate of LEEP histology with punch biopsy was 60% (53 cases). In comparison to punch biopsy, the higher LEEP histologic rate was 22% (19 cases), and lower LEEP histologic rate was 18% (16 cases), respectively. 2. 67 patients were diagnosed CIS and among them 58 patients underwent hysterectomy. In histologic comparison between LEEP and hysterectomy, there were on 1 (1.7%) patient who had more advanced diagnosis after operation. 3. 67 patients were diagnosed CIS and among them 58 patients underwent hysterectomy. The residual lesion was identified in 19 of 58 patients (33%).
CONCLUSION
LEEP was useful diagnostic tool in CIS. But, in therapeutic efficacy, simple LEEP seems to be incomplete. Therefore, when we use LEEP for CIS as therapeutic tool, additional procedure, such as wide excision or endocervical deep resection may be asked. And careful follow up asked in therapeutic LEEP.