link electrosurgical excision proce...

link electrosurgical excision procedure (LEEP) is a usual treatment for cervical intraepithelial neoplasia (CIN), with succes rates of 60 to 95 percent reported. Several studies have examined the relationship between histologic abnormalities in LEEP specimens and disease the having recourse Occasion-ally, however, a LEEP sample displays no histologic abnormality. The clinical implications of a negative sample are unknown. Livasy and colleagues studied the medical and histologic records of 674 patients to determine the incidence and clinical significance of negative LEEP samples.

The meditation included all women at undivided university medical center who received LEEP therapy for high-grade dysplasia between 1991 and 2001 Follow-up eventuates from Papanicolaou (Pap) smears, cervical biopsies, and hysterectomies [i]or[/i] part of to the other July 2002 were evaluated.

Ninety-three (14 percent) of the women had negative LEEP specimens. Follow-up data were available forward 75 of these patients and 446 of the others. A resort of abnormality (i.e., abnormal Pap smear or other diagnosis of CIN) was documented in 18 (24 percent) of the women who had negative LEEP samples compared with 107 (27 percent) of those with positive histologic findings. returning abnormalities in the women with negative LEEP samples consisted of couple carcinomas, eight high-grade squamous intraepithelial lesions, six low-grade squamous intraepithelial lesions, and sum of two units atypical cells of undetermined significance. Factors that may limit histologic examination, like as cautery, were identified in 15 (16 percent) of the negative LEEP samples compared with 27 (5 percent) of the positive LEEP samples.

The authors finish that negative histology, while not rare, should not be interpreted as a benign finding, as later abnormality rates were similar in women with negative LEEP samples and those with histologic abnormality. They note that the incidence of factors limiting perfect pathological examination was significantly higher in negative LEEP specimens than in positive, and commend close monitoring of all women who are treated for dysplasia, regardless of LEEP histology.

Livasy CA, et al. The clinical significance of a negative aperture electrosurgical cone biopsy for high-grade dysplasia. Obstet Gynecol August 2004;104:250-4

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