The case for cytologic follow-up after LEEP.
OBJECTIVE
To examine our loop electrocautery excisional procedure (LEEP) biopsy experience to assess the incidence of abnormal follow-up and relate this to margin status.


METHODS
Records of 162 LEEP procedures performed between January 1992 and April 1994 were reviewed to evaluate margin readability and status. All follow-up cytologic or histologic specimens were examined.


RESULTS
After a mean 10.9-month follow-up, of 162 cases, 67 had a negative study (41.4%). Fifty-four (33.3%) had an abnormal result, with high grade squamous intraepithelial lesion (HSIL) in 16 cases (13.2%) of all LEEPs with follow-up, low grade squamous intraepithelial lesions in 27 (22.3%) and squamous atypia in 11 (9.1%). On microscopic review of these 54 cases, 37 had a readable margin (68.5%); of these readable margins, 12 (32.4%) were positive. Forty-one cases (25.3% of all LEEPs) had no follow-up study.


CONCLUSIONS
The high incidence of HSIL after LEEP highlights the need for vigilant follow-up. Prediction of follow-up by margin status is dubious. Thermal artifact makes the margin uninterpretable in many cases, and two-thirds of cases with abnormal follow-up occurred where the LEEP margin was negative. Our finding of no follow-up for 25% of LEEPs performed is particularly disturbing in light of these results.
Hanau
C A
CA
Department of Anatomy, Pathology and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Bibbo
M
M
D016477:Artifacts; D001706:Biopsy / Q000379:methods*; D002584:Cervix Uteri / Q000473:pathology* / Q000601:surgery; D019092:Conization / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology*