Abstract:

Objective To investigate the values of colposcopic cervical biopsy, pathology after loop electrosurgical excision procedure (LEEP) and the combined examinations of colposcopic cervical biopsy and LEEP in the early diagnosis of cervical precancerous lesions and cervical cancer. Methods Five hundred and fifty-four patients with abnormal findings in cervical cytology and/or human papillomavirus (HPV) test or with normal findings in these screening tests while having moderate to severe cervical columnar eversion were subject to colposcopic cervical biopsy and LEEP, and the pathological findings were compared before and after LEEP. Results The total coincidence rate of colposcopic cervical biopsy and pathology after LEEP was 49.82%. In patients diagnosed as cervical intraepithelial neoplasia (CIN) Ⅰ by cervical biopsy, 14.36% were diagnosed as CINⅡ/Ⅲ after LEEP. In patients diagnosed as CIN Ⅱ/Ⅲ (including carcinoma in situ)  by cervical biopsy, 3.89% were diagnosed as invasive carcinoma after LEEP. Kappa coefficient was 0.62 in the consistency of diagnosis of CINⅡ/Ⅲ by two methods. Kappa coefficient was 0.80 in the consistency of diagnosis of CINⅡ/Ⅲ by colposcopic cervical biopsy and combined examinations of colposcopic cervical biopsy and LEEP, and that was 0.84 by pathology after LEEP and combined examinations of colposcopic cervical biopsy and LEEP. The total accuracy of colposcopic cervical biopsy was 81.77%, and the misdiagnosis rate of CINⅡ/Ⅲ was 20.64%. Conclusion Colposcopic cervical biopsy and pathology after LEEP are effective measures for diagnosis of CIN and microinvasive cervical carcinoma. Colposcopic cervical biopsy may misdiagnose high-level CIN and microinvasive cervical carcinoma, and the combined examinations can improve the accuracy of diagnosis.

Key words: cervical intraepithelial neoplasia, cervical carcinoma, colposcope, colposcopic cervical biopsy, loop electrosurgical excision procedure