title: Random biopsy in colposcopy-negative quadrant is not effective in women with positive colposcopy in practice.
abstract: OBJECTIVE
  To assess the efficacy of random biopsy in diagnosing those high-grade squamous intraepithelial lesions or carcinomas (HSIL+) missed by colposcopy-directed biopsy, and to identify the scenarios of cervical cancer screening when random biopsy is necessary.
  
  
  METHODS
  Data from 1997 women who participated in the Shanxi Province Cervical Cancer Screening Study I (SPOCCS I) were reviewed. Each woman received human papillomavirus (HPV) testing with the second-generation hybrid capture, liquid-based cytology, four-quadrant biopsy and endocervical curettage. The final diagnosis was based on the most severe pathological result obtained. The efficacy of random biopsy and colposcopy-directed biopsy was evaluated on the basis of the final pathological results.
  
  
  RESULTS
  For women with severe cytological abnormalities (HSIL+) and negative colposcopy, the yield of HSIL+ diagnosed by random biopsy was 25%. On the other hand, the yield of HSIL+ diagnosed by random biopsies in the negative quadrant was no more than 4% when the colposcopy was positive, regardless of the cytological findings. For women with negative HPV, no HSIL+ was found by random biopsy. For women with severe cytological abnormalities (HSIL+) and positive HPV, the yield of HSIL+ diagnosed by random biopsy was 35% when colposcopy was negative. For women with low-grade intraepithelial lesion (LSIL) and positive HPV, the yield of HSIL+ diagnosed by random biopsy was 12.5% when colposcopy was negative.
  
  
  CONCLUSIONS
  Random biopsy is not effective in the negative quadrant in women with positive colposcopy, but should be performed in women with cytological HSIL+ but negative colposcopy, or in those with cytological LSIL or HGSL+ and positive HPV but negative colposcopy.
authors: Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: Yan
authors: Y
authors: Song
authors: Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: Yu-Qian
authors: YQ
authors: Zhao
authors: Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. Electronic address: zhangxun7508@163.com.
authors: Xun
authors: X
authors: Zhang
authors: Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: Xiao-Yang
authors: XY
authors: Liu
authors: Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: Ling
authors: L
authors: Li
authors: Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: Qin-Jing
authors: QJ
authors: Pan
authors: Department of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: Gui-Hua
authors: GH
authors: Shen
authors: Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: Fang-Hui
authors: FH
authors: Zhao
authors: Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: Feng
authors: F
authors: Chen
authors: Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. Electronic address: chenwen@cicams.ac.cn.
authors: Wen
authors: W
authors: Chen
authors: Department of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors: You-Lin
authors: YL
authors: Qiao
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods*; D003127:Colposcopy / Q000379:methods*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology
keywords: Cervical intraepithelial neoplasia; Colposcopic-directed biopsy; Colposcopy; Random biopsy