Retrospective Analysis Of Preoperative Pathological Diagnosis Of High Grade Cervical Intraepithelial Neoplasia With Hysterectomy

Objective:A comparative analysis was carried out by the pathological results of colposcopy biopsy,intraoperative frozen section pathology and consistency paraffin section examination of cervical conization specimens to study the preoperative pathological diagnosis of high grade cervical intraepithelial neoplasia before hysterectomy.Methods:A retrospective study was carried out in 454 cases with CIN II-III underwent colposcopy biopsy then conization of cervix,between January 2010 and December 2015in our hospital,among them,303 patients with frozen pathology were given conization at the same time.238 cases of patients were treated with frozen pathology immediately after cervix conization,In addition,216 cases of the patients were reoperated after the cervical conization,by contrast colposcopy biopsy,intraoperative frozen section pathology and consistency paraffin section examination of cervical conization specimens and by contrast the consistency of pathology after cervical conization and hysterectomy.Results:1.The diagnosis coincidence rate of colposcopy biopsy and intraoperative frozen section pathology was 89.11%(270/303),CINII was 63.33%(38/60),22 cases were upgraded to CINIII;CINIII was 95.47%(232/243)11 cases were upgraded(9cases wereupgraded to IA1,2 cases are upgraded to IB1).2.The coincidence rate between the biopsy of the colposcopy and the pathological diagnosis of paraffin was 77.75%(353/454).CINII was 22.99%(20/87),67 cases were upgraded(57 cases were upgraded to CINIII,8 cases were upgraded to cervical cancer stage IA1,2 cases were upgraded to IA2 stage),CINIII was 90.46%(332/367),35 cases were upgraded(26 cases were upgraded to cervical cancer IA1 stage,7 cases were upgraded to IB1 stage,2 cases were upgraded to IIA stage).3.303 cases of frozen histopathological patients in cervical conization,the coincidence rate between frozen pathology and paraffin pathological diagnosis in cervical conization was 88.12%(267/303).CINII was 60%(36/60),24 cases were upgraded(18 cases were upgraded to CINIII,5 cases were upgraded to cervical cancer stage IA1,1 cases were upgraded to IA2 stage),CINIII was 95.06%(231/243),12cases were upgraded(9 cases were upgraded to cervical cancer IA1 stage,2 cases were upgraded to IB1 stage,1 cases were upgraded to IIA stage).4.303 cases of frozen histopathological patients in cervical conization,the diagnostic accuracy of intraoperative frozen section pathology is higher than colposcopy biopsy in statistically significant(?~2=27.68,P?0.05).5.216 cases of the patients are reoperated after the cervical conization,the accuracy of conization ofcervix for the diagnosing of high grade squamous intraepithelial lesion and invasive cervical cancer could reach 99.07%(214/216).Conclusion:Colposcopy biopsy is a preliminary diagnosis of high grade squamous intraepithelial lesion;Cervical conization has the role of diagnosis and treatment,which can significantly reduce the rate of missed diagnosis of invasive cervical cancer.Frozen section examination can be found in the early part of microinvasive carcinoma and invasive carcinoma,but there is still a certain rate of misdiagnosis and missed diagnosis in the diagnosis of CIN.Therefore,it is suggested that cervical conization should be performed first for all patients with high-grade cervical intraepithelial neoplasia,and then the hysterectomy can be performed after the paraffin pathology is returned,so as to achieve the standard treatment.