title: Colposcopic directed biopsy in the management of abnormal pap smear at Phramongkutklao Hospital.
abstract: OBJECTIVE
  To evaluate agreement in pathologic diagnosis of tissue obtained by colposcopic directed biopsy (CDB) and conization or total abdominal hysterectomy (TAH) in the diagnosis of cervical intraepithelial neoplasia (CIN).
  
  
  METHODS
  Medical records of women with abnormal cervical cytology referred for colposcopic examination from January 1, 1999 to December 31, 2003 were reviewed. Agreement in diagnosis of CIN in tissue obtained by CDB and tissue obtained by conization or TAH is defined as not more than one level of CIN disparity.
  
  
  RESULTS
  Agreement between pathologic diagnosis of tissue from CDB and tissue from conization or TAH is 67.1% with a 95% confidence interval of 57-77%. Six cases of invasive cancer were not diagnosed from CDB but subsequently diagnosed from conization.
  
  
  CONCLUSIONS
  Agreement between pathologic diagnosis of tissue obtained from CDB and tissue from conization or TAH in the present study was too low to accept CDB as a diagnostic modality for CIN in selected cases. Conization should be performed in these cases after diagnosis of CIN is made by CDB.
authors.affiliation: Department of Obstetrics and Gynecology, Phramongkutklao Hospital, Bangkok, Thailand.
authors.forename: Suttida
authors.initials: S
authors.lastname: Intharaburan
authors.forename: Ittipat
authors.initials: I
authors.lastname: Rakdang
authors.forename: Yawana
authors.initials: Y
authors.lastname: Tanapat
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods; D003127:Colposcopy; D019092:Conization; D005260:Female; D006801:Humans; D007044:Hysterectomy; D065006:Papanicolaou Test; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013785:Thailand; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology*