Efficacy of Large Loop Excision of the Transformation Zone (LLETZ) in the Treatment of Cervical Intraepithelial Neoplasia

Jeon, Hye Won

Abstract

OBJECTIVE
This study was performed to assess the efficacy of large loop excision of transformation (LLETZ) and to evaluate of clinicopathological factors with the probability of residual disease.
METHODS
Retrospective study was performed in 56 patients treated with LLETZ from September, 1998 to October, 2001 in department of Obstetrics and Gynecology at Boramae Hospital. The patients underwent either immediate reoperation or monitoring with a cytologic smear and colposcopy. we investigate the significance of clinicopathological factors to predict residual disease after LLETZ. We used the Hybrid capture II test (Digene, USA) for presence of human papillomavirus (HPV). Residual disease was defined as histologic diagnosis of cervical intraepithelial neoplasia (CIN).
RESULTS
Histologic assesment after LLETZ showed margin involvements in 28.6% (16/56) of cases but the residual lesion was only seen in 21.4% (12/56). There was no other serious complication. Positive margins was significantly associated with severity of lesion but not presence of HPV. Severity of lesion and margin involvements was significantly associated with residual disease (p<0.05). But age of patients and the presence of HPV was not significantly associated with residual disease.
CONCLUSION
LLETZ is an effective, quick and reliable procedure on accurate diagnosis of cervical pathology and conservative treatment of CIN. Margin status and severity of lesions could be used to predict residual disease.