Clinical observation of diseases in cervix of the uterus by LEEP with the help of colposeopy / 中国基层医药

Objective To explore the ellnieal effect of the diagnosis and the treatment of the disease in cer-vix of the uterus by LEEP with the help of eolposcopy. Methods 268 women with different kinds of disease in cervix of the uterus were selected, which were preliminarily diagnosed by gynecological examination, the examination of the exfoliative cells of cervix of the uterus, the examination by colposeope and the biopsy. LEEP surgery was used to treat them, and we carried out pathological examination of the surgery specimen and watched the time of operation, the a-mount of bleed and the effect of treatment. Results The average time is 5.8min, the average amount of bleeding is 6.7ml. No secondary infection. The dear diagnosis is determined by pathological exmaination of surgery specimens. Conclusion The operation is simple,safe,short operation time and less bleeding by LEEP surgery with the help of colposcope, and less water after the operation. It has good effect and can provide complete pathological specimen. Be-aides,the diagnosis can be taken simtdtaneously when treatment.

The Comparative Analysis of Cytology, Colposcopically Directed Biopsy and Final Histopathology in Diagnosis of Cervical Neoplasia / 대한산부인과학회잡지

OBJECTIVE: To investigate the necessity of colposcopically directed biopsy for more accurate detection of cervical neoplasm. METHODS: Cytology and colposcopically directed biopsy were performed in 114 patients and the patients were subsequently underwent conization or hysterectomy from January, 1998 to December, 2001. RESULTS: The complete diagnostic agreement of cytology with permanent biopsy was 57.9% (66 of 114) and the diagnostic agreement within one degree was 80.6% (92 of 114). The complete diagnostic agreement of colposcopically directed biopsy with permanent biopsy was 62.3% (71 of 114) and the diagnostic agreement within one degree was 85.1% (97 of 114). The difference between two tests was statistically significant (p<0.001). CONCLUSION: We concluded that colposcopically directed biopsy can reduce the false negative rate of cytology for screening test of cervical neoplasm. The difference between colposcopically directed biopsy and permanent biopsy was caused by inappropriate resection of the lesion and unskilled physician.

Diagnostic Accuracy of Cytology, Colposcopically Directed Biopsy and Conization and Predictive Factors for Residual Tumor after Conization in Patients with Cervical Neoplasia / 대한산부인과학회잡지

OBJECTIVE: This study was performed to evaluate the diagnostic accuracy of cytology, colposcopically directed biopsy and conization and to analyze predictive factors for residual tumor after conization in patients with cervical neoplasia. METHODS: We reviewed 167 patients who had undergone cytology, colposcopically directed biopsy and conization followed by subsequent hysterectomy depending on their current disease status at the Department of Obstetrics & Gynecology, Catholic University of Korea Medical College, Holy Family Hospital from January, 1993 to August, 1998. The diagnostic accuracy of cytology, colposcopically directed biopsy and conization were investigated. Also, we investigated the significance of the margin status and the presence of HPV which were used to predict residual tumors in hysterectomy specimens after conization. RESULTS: The results of each methods were analyzed with regard to the histopathologic findings of the surgical specimen. The accuracy rates of cytology, and colposcopically directed biopsy were 59.3% (99 of 167) and 71.3% (119 of 167), respectively. After conization, residual tumors were found in 30.1% of subsequent hysterectomized specimens (51 of 167). Underestimation by conization occurred in 2.0% of cases (1 of 51) and overestimation in 7.8% (4 of 51). Residual tumors were significantly more frequent in patients with positive conization margins than in those with negative margins (P<0.001). But the presence of HPV was not significant. CONCLUSION: These results suggest that diagnostic conization seems to be essential procedure in patients showing abnormal results by cytology and colposcopically directed biopsy, especially in those with CIN III or microinvasion, for the further proper management of cervical neoplastic lesion and margin status is useful in predicting residual tumor after conization.