The accuracy of cervical cancer and cervical intraepithelial neoplasia diagnosis with loop electrosurgical excisional procedure under colposcopic vision

다국어 초록 (Multilingual Abstract)

Objective: The colposcopic vision guided loop electrosurgical excisional procedure (LEEP) was studied for the
effective diagnosis of cervical cancer and cervical intraepithelial neoplasia (CIN).
Methods: A total of 199 patients participated in this study. Individual cases were from gynecologic outpatients at
Thammasat University Hospital, Thailand. These had diagnoses for CIN and were selected for treatment with
colposcopic guided LEEP. The average age of patients in this study was 45. Menopausal women represented 31%,
(61/199) of the patients. The most frequently found Pap smear result among these women (44%, 88/199), was that
of high-grade squamous intraepithelial lesion. The next most frequent Pap smear result (32%, 64/199) was low-grade
squamous intraepithelial lesion. Patients’ medical records and outcomes were evaluated for consistency of
pathological examination between colposcopic directed biopsy and LEEP. Discrepancies between initial diagnosis and
the final diagnosis were also analyzed.
Results: The colposcopic guided LEEP accurately determined 100% of the cervical cancer cases and 84.8 % of the
high-grade squamous intraepithelial lesion cases. Involvement of the ectocervical or endocervical margin regions was
found to be 5% and 10% respectively, in this study. Excessive bleeding complication, either during the excision and/or
postoperative recovery was found in 3% and 6% of cases, respectively.
Conclusion: LEEP under colposcopic vision is a recommended technique for ambulatory management of precancerous
lesion and early diagnosis of cervical cancer. This technique significantly reduces rate of positive ectocervical cone
margin involvement.

다국어 초록 (Multilingual Abstract)

Objective: The colposcopic vision guided loop electrosurgical excisional procedure (LEEP) was studied for the
effective diagnosis of cervical cancer and cervical intraepithelial neoplasia (CIN).
Methods: A total of 199 patients participated in this study. Individual cases were from gynecologic outpatients at
Thammasat University Hospital, Thailand. These had diagnoses for CIN and were selected for treatment with
colposcopic guided LEEP. The average age of patients in this study was 45. Menopausal women represented 31%,
(61/199) of the patients. The most frequently found Pap smear result among these women (44%, 88/199), was that
of high-grade squamous intraepithelial lesion. The next most frequent Pap smear result (32%, 64/199) was low-grade
squamous intraepithelial lesion. Patients’ medical records and outcomes were evaluated for consistency of
pathological examination between colposcopic directed biopsy and LEEP. Discrepancies between initial diagnosis and
the final diagnosis were also analyzed.
Results: The colposcopic guided LEEP accurately determined 100% of the cervical cancer cases and 84.8 % of the
high-grade squamous intraepithelial lesion cases. Involvement of the ectocervical or endocervical margin regions was
found to be 5% and 10% respectively, in this study. Excessive bleeding complication, either during the excision and/or
postoperative recovery was found in 3% and 6% of cases, respectively.
Conclusion: LEEP under colposcopic vision is a recommended technique for ambulatory management of precancerous
lesion and early diagnosis of cervical cancer. This technique significantly reduces rate of positive ectocervical cone
margin involvement.

참고문헌 (Reference)

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