open access

Vol 94, No 1 (2023)
Research paper
Published online: 2022-08-23
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Histopathological discrepancies between colposcopy-directed biopsy and LEEP-conization observed during SARS-CoV-2 pandemic

Dominik Pruski12, Marcin Przybylski13, Sonja Millert-Kalinska41, Andrzej Zmaczynski5, Robert Jach5
·
Pubmed: 36043301
·
Ginekol Pol 2023;94(1):12-18.
Affiliations
  1. Department of Obstetrics and Gynecology, District Public Hospital in Poznan, Poland
  2. Dominik Pruski MD. Gynecology Specialised Practise Poznan, Poland, Poland
  3. Marcin Przybylski M.D. Gynecology Specialised Practise Poznan, Poland, Poland
  4. Poznan University of Medical Sciences, Poland, Poland
  5. Department of Gynecological Endocrinology, Jagiellonian University Medical College, Cracow, Poland, Poland

open access

Vol 94, No 1 (2023)
ORIGINAL PAPERS Gynecology
Published online: 2022-08-23

Abstract

Objectives: Long-term exposure to the human papillomavirus (HPV) is a known cause of squamous intraepithelial lesions that lead to cervical cancer. The loop electrosurgical excision procedure (LEEP) conization is an established treatment method. According to the latest recommendations, we present a paper to evaluate the effectiveness of various diagnostic methods of squamous intraepithelial lesions. Material and methods: We analyzed 229 patients who reported to District Public Hospital in Poznan to undergo LEEP conization in 2019–2021 during the SARS-CoV-2 Pandemic. The analysis included Pap smear/liquid-based cytology, HPV genotyping, colposcopy with targeted biopsy and LEEP-conization. We offered post-treatment HPV vaccination and, as a follow-up, performed HPV re-genotyping after six months. Results: In total, 89.1% of patients were HPV-positive. The coloscopy-directed biopsy (CDB) results show that almost 70% of the patients had high-grade intraepithelial lesions (HSIL). The diagnosis obtained by LEEP-conization showed that half of the women were diagnosed with HSIL and one-third with the low-grade squamous intraepithelial lesion (LSIL). The sensitivity of Pap smear/LBC accounted for 93.7% and was lower than for CDB, which reached 95.1%. Both diagnostic methods tend to underestimate the final diagnosis. Conclusions: The inclusion of a colposcopic examination in an in-depth diagnostic process in women with abnormal Pap smear results facilitates the identification of patients requiring therapeutic intervention. LEEP-conization may be used without the primary biopsy. It applies to multiparous women in the perimenopausal period, extensive abnormalities, discrepancies in test results, extensive visible abnormalities, and suspicion of invasive cervical cancer in the colposcopic examination.

Abstract

Objectives: Long-term exposure to the human papillomavirus (HPV) is a known cause of squamous intraepithelial lesions that lead to cervical cancer. The loop electrosurgical excision procedure (LEEP) conization is an established treatment method. According to the latest recommendations, we present a paper to evaluate the effectiveness of various diagnostic methods of squamous intraepithelial lesions. Material and methods: We analyzed 229 patients who reported to District Public Hospital in Poznan to undergo LEEP conization in 2019–2021 during the SARS-CoV-2 Pandemic. The analysis included Pap smear/liquid-based cytology, HPV genotyping, colposcopy with targeted biopsy and LEEP-conization. We offered post-treatment HPV vaccination and, as a follow-up, performed HPV re-genotyping after six months. Results: In total, 89.1% of patients were HPV-positive. The coloscopy-directed biopsy (CDB) results show that almost 70% of the patients had high-grade intraepithelial lesions (HSIL). The diagnosis obtained by LEEP-conization showed that half of the women were diagnosed with HSIL and one-third with the low-grade squamous intraepithelial lesion (LSIL). The sensitivity of Pap smear/LBC accounted for 93.7% and was lower than for CDB, which reached 95.1%. Both diagnostic methods tend to underestimate the final diagnosis. Conclusions: The inclusion of a colposcopic examination in an in-depth diagnostic process in women with abnormal Pap smear results facilitates the identification of patients requiring therapeutic intervention. LEEP-conization may be used without the primary biopsy. It applies to multiparous women in the perimenopausal period, extensive abnormalities, discrepancies in test results, extensive visible abnormalities, and suspicion of invasive cervical cancer in the colposcopic examination.

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Keywords

cervical cancer; CDB, squamous intraepithelial lesion

About this article
Title

Histopathological discrepancies between colposcopy-directed biopsy and LEEP-conization observed during SARS-CoV-2 pandemic

Journal

Ginekologia Polska

Issue

Vol 94, No 1 (2023)

Article type

Research paper

Pages

12-18

Published online

2022-08-23

Page views

3323

Article views/downloads

728

DOI

10.5603/GP.a2022.0081

Pubmed

36043301

Bibliographic record

Ginekol Pol 2023;94(1):12-18.

Keywords

cervical cancer
CDB
squamous intraepithelial lesion

Authors

Dominik Pruski
Marcin Przybylski
Sonja Millert-Kalinska
Andrzej Zmaczynski
Robert Jach

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