Tsetsa P, Haidopoulos D, Rodolakis A, Thomakos N, Vlachos G, Pappa K, Sakellaropoulos G, Kalpaktsoglou, K, Papaspirou E, Sotiropoulou M, Papaefthimiou, M, Antsaklis A

1st Department of Obstetrics and Gynecology, University of Athens, Medical School, Alexandra hospital, Athens, Greece

Correspondence: Tsetsa Paraskevi, 1st Department of Obstetrics and Gynecology, University of Athens, Medical School, Alexandra hospital, Athens, 80 Vasilissis Sofias Avenue, GR-11528. Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

 


 

Abstract

Aim of the study: To assess the degree of agreement between cytology, punch biopsy and cone histology, the percentage of positive cone margins and to define the parameters related to recurrence in women with cervical intraepithelial neoplasia.

Materials and methods: A total of 299 cone biopsies performed either by LLETZ or Laser were studied. The Pap smears were examined by two consultant cytologists whereas the punch biopsies and the cones were evaluated by two consultant pathologists.

Results: The percentage of agreement between cytology and cone histology was 58% whereas that of punch biopsies and cone histology, was 52%. Negative cone margins were found in 81%. The percentage of positive cone margins was found to be significantly higher in cases where conization was performed in more than two pieces (p<0.001) and in cases of thermal injury (p=0.035).

Conclusions: The degree of agreement between cytology and cone biopsy histology was found to be moderate, whereas this of punch biopsy histology and cone biopsy was found to be high. Positive cone margins were found to be directly related to the number of cervical pieces removed during conization and to thermal injury of the cone.

Key words: conization; cervical intraepithelial neoplasia; surgical margins; thermal injuries; cone depth