ABSTRACT
Objective Cold knife conization combined with frozen section were usually used in assessing the severity of the disease and the scope of the operation in cervical intraepithelial neoplasia class Ⅲ (CIN Ⅲ) patients before the total hysterectomy.In this study,LEEP biopsy combined with frozen section was used for preoperative assessment in CIN Ⅲ patients.The clinical value of this approach in assessing disease severity and operation scope before total hysterectomy will be analyzed.Methods We retrospectively analyzed the results of colposcopy biopsy,LEEP biopsy frozen sections,paraffin sections and postoperative residual cervix pathological biopsy in 168 cases with CIN Ⅲ admitted to our hospital from January 2011 to December 2012.Results LEEP biopsy combined with frozen sections showed that 64.88％ (109/168) results of frozen section were consistent with the results of cervical colposcopy biopsy,22.02％ (37/168) were degraded and 13.09％ (22/168) were upgraded to microfocal invasive cancer or invasive cancer.The pathological results of paraffin section showed that 109 cases(64.88％) of CIN Ⅲ lever,33 cases (19.6％) of inflammatory and CIN Ⅰ-H,26 cases (15.4％) of micro invasive carcinoma and invasive carcinoma were consistent with the results of cervical colposcopy biopsy.The accuracy of LEEP frozen biopsy was 95.2％ (κ=0).Among the 146 residual cervixs of CIN Ⅲ patients diagnosised by LEEP biopsy,51.3 ％ (75/146) had pathological changes.Comparison of cervical col poscopy biopsy and final diagnosis,26 cases of invasive cancer were missed diagnosis by cervical colposcopy biopsy.Conclusion LEEP biopsy combined with frozen section can provide a quick and accurate assessment before cystectomy in CIN Ⅲ patients.It is feasible to determine the surgical range according to frozen section biopsy.