Large loop excision of the transformation zone (LLETZ) is an established method for the treatment of CIN since it combines the advantages of an outpatients procedure with excision of the lesion and histologic confirmation.
Objective is to compare the sensitivity and specificity of abnormal cytology ≥ASCUS and colposcopy vs the histologic results of punch biopsy and loop cone specimen .Information is presented on excision margins and recurence of the lesion.
Retrospective study of 129 patients , aged 33± 9,3 yrs over a 4 yrs period ,that underwent LLETZ for cervical dysplasia. The specificity and sensitivity of cervical smears ≥ASCUS and colposcopy were compared for the diagnosis of low grade or high grade lesions as diagnosed by final histology. Statistical significance was calculated with t test.
Of 129 patients 98 underwent punch biopsy and more and 63 had an excisional procedure . The sensitivity and specificity of cervical smear for LGSIL was 40% and 75% and of colposcopy was 90% and 76,7%. The sensitivity and specificity of cervical smear for HGSIL was 40,7% and 80% and of colposcopy was 78% and 80% .Colposcopy was more accurate than cytology in the correct diagnosis of SIL (p=0.0002) . The final histology was LGSIL in 12 patients (19%) ,HGSIL in 41 (65%) ,invasive cancer in 3 (5%) and no lesion in 8 (13%). Two patients had positive margins (3%) and 2 (3%) reccured after a median follow up of 20 months.
Colposcopy is a more accurate method for assessing SIL. Histologic confirmation by an excisional procedure is an effective method of treatment of SIL.