Pathology Analysis For The Diagnostic Method And Treatment In 191 Patients With HSIL

Objectives: To evaluate the accuracy of colposcopy biopsy for the diagnosis of CINâ…¡~â…¢,using the histologic findings of cold-knife conization(CKC)as a gold standard. The second objective was to report the value of CKC in the treatment of CINâ…¡~â…¢.Methods: A retrospective study was carried out in 191 cases with CINâ…¡~â…¢, which are diagnosed by colposcopy biopsy before admission and performed the surgeries of CKC or hysterectomy between January 2005 and February 2009 at the Forth Subordinate Hospital of Hebei Medical University.Results: Within all the 191 patients, 66 were diagnosed as CINâ…¡according to the colposcopy biopsy. And then 45 of them received CKC, 14 were performed Hysterectomies, and 7 were performed Hysterectomies after CKC. As well, 106 were diagnosed as CINâ…¢according to the colposcopy biopsy. And then 63 of them only received CKC, 12 were performed Hysterectomies, and 31were performed Hysterectomies after CKC. There were 19 diagnosed as CIS according to the colposcopy biopsy. And then 3 of them only received CKC, 12 were performed Hysterectomies, and 4 were performed Hysterectomies after CKC. There were 111 of the 191 cases received CKC, and 10(9.0%)of them got higher grade of pathological diagnosis than colposcopy biopsy, meanwhile 79(71.2%) equally, and 22(19.8%)lower. Hysterectomies were performed just after the colposcopy biopsy in 38 cases, and 5(13.2%)of them got higher grade of pathology than biopsy. Whereas one was diagnosed as invasive cancer, and received chemical therapy (BEP for 6 period). At the same time, 16(42.1%)of the 38 cases had equally results ,and 7(44.7%)were identified as lower grade. In 42 cases which were performed hysterectomies after the CKC, none of them had higher grade of pathology than the colposcopy biopsy, 4(9.5%)got equally results, 13(31%)had lower ones, and 25(59.5%)were inflammation meaning healed. The efficiency of colposcopy biopsy on diagnosis is 89.5%. The comparison of pathologic results between CKC and colposcopy biopsy and the statistic analysis of it indicated that both of the diagnostic methods could be effective for diagnosing of HSILs. The comparison of pathologic results between CKC and additionally hysterectomies and the statistic analysis of it indicated that,the accuracy of the CKC for the diagnosing of HSILs could reach 100%,and cure rate could be 59.5%.Conclusions: Colposcopy biopsy is an simple and efficacious method in screening and diagnosis for the CINâ…¡~â…¢, but not that accurate. So that CKC can not be instead by the colposcopy biopsy in diagnosis. The optical therapy for CINâ…¡~â…¢is CKC. Further treatments such as hysterectomy or follow-up are acceptable after that based on the pathological results, age, childbearing desire, and other gynecological complications.