[Evaluation of cold knife conization (CKC) on diagnosis and treatment of cervical intraepithelial neoplasia].
OBJECTIVE
Cold knife conization (CKC) is a classic diagnostic and therapeutic procedure. The authors analyzed pathological features of 62 cone specimens and determined the effectiveness of CKC on diagnosis and treatment of cervical intraepithelial neoplasia (CIN).


METHODS
Comparative analysis on pathological findings of cone specimens and multiple biopsies (MB) of 62 CIN patients was performed.


RESULTS
There were close similarities in pathology between CKC and MB in 44 cases (71%). Eighteen cases (29%) showed histological difference between CKC and MB; among them, 4 cases that were given a diagnosis of CIN2 or CIN3 by MB were classified into CIN3 or microinvasive carcinoma by CKC. All 62 cases were squamous epithelial lesions; 34 of them subjected to CIN3 or higher than CIN3. The lesions were mainly located in transformation zone, mostly with cervical canal involvement. Thirty cases showed equal to or more than 2 quadrants involved. Thirty-seven cases (59.7%) had histological evidences for HPV infection. Thirty-one cases(50%) had squamous metaplasia, some with variable dysplasia. Resection margin positive rates were 3.2%(>or=CIN2) and 8.1% (CIN1), respectively, lower than those by loop electrosurgical excision procedure (Leep) reported in literature. Fifty-six cases were closely followed up after operation (4 months-14 years). No recurrences were found and 3 patients had pregnancy and delivery.


CONCLUSIONS
CKC is significantly effective and cannot be replaced by MB. Squamous metaplasia and CIN development are intrinsically correlated with each other.
Zhang
Xun
X
Department of Pathology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100021, PR China.
Li
Ling
L
Zhang
Wen-Hua
WH
Li
Shu-Min
SM
D000328:Adult; D002584:Cervix Uteri / Q000601:surgery*; D019092:Conization / Q000379:methods*; D005260:Female; D006801:Humans; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*