Conization, frozen section examination, and planned hysterectomy in the treatment of high-grade cervical intraepithelial neoplasia
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
;
56(6): 169-172, Nov.-Dec. 2001. ilus, tab
Article
in English
| LILACS
| ID: lil-301396
RESUMO
PURPOSE:
We tested the role of frozen section examination of the cone specimen in the evaluation of the resection margin status and to rule out invasion in patients with high-grade cervical intraepithelial neoplasia.METHODS:
Twenty-five patients with cervical intraepithelial neoplasia underwent conization followed by frozen section examination and planned hysterectomy. The results of the definitive paraffin exam were compared with frozen section examination.RESULTS:
In the evaluation of the margins by frozen section examination, 16 patients (64 percent) had positive cone margins and 9 (36 percent) had negative margins. The definitive paraffin examination of margin status was concordant in all the cases. Intraoperative diagnosis of invasion was made in 5 cases, and 1 of these was microinvasive. Among the remaining 20 cases, we detected 2 additional microinvasive carcinomas after paraffin study, so the diagnosis of the frozen section examination was concordant with the paraffin sections in 23/25 cases (92 percent). Two cases of microinvasive carcinoma were diagnosed as cervical intraepithelial neoplasia by frozen section examination and had less than 2 mm stromal invasion.CONCLUSIONS:
In high-grade cervical intraepithelial neoplasia, frozen section examination can provide immediate and precise evaluation of the cone margin status in high-grade cervical intraepithelial neoplasia. It can identify frank invasion and permit adequate treatment in a one-stage procedure. In early microinvasive disease, frozen section examination fails to detect the area of invasion but reliably detects clear resection margins
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Uterine Cervical Dysplasia
/
Uterine Cervical Neoplasms
/
Conization
/
Frozen Sections
/
Hysterectomy
Type of study:
Observational study
Limits:
Adult
/
Female
/
Humans
Language:
English
Journal:
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
Journal subject:
Medicine
Year:
2001
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
University of Säo Paulo/BR
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