title: Quality evaluation of cone biopsy specimens obtained by large loop excision of the transformation zone.
abstract: BACKGROUND
  Large loop excision of the transformation zone (LLETZ) has been used for the diagnosis and treatment of precancerous cervical lesions, and it is the first choice of treatment in the majority of cervical pathology services. The aim of this study was to evaluate the presence of thermal artifacts, the need for serial sections, the percentage of clear and involved resection margins and the relationship between endocervical gland involvement and the severity of the lesion in samples resected using LLETZ.
  
  
  METHODS
  A retrospective study was performed at Santa Casa de Misericordia School of Science (HSCMV), Vitoria, Espirito Santo, Brazil with a sample of 52 histopathology slides from patients submitted to conization because of abnormal cytology findings and a biopsy result of cervical intraepithelial neoplasia (CIN) 2, CIN 3 and adenocarcinoma in situ. Statistical analysis was performed using Student's t-test.
  
  
  RESULTS
  Serial sections were required to confirm diagnosis in four of 52 cases. Thermal artifacts were present in all cases, with grade I being the most common (94.2% of cases). Clear margins were found in 96.2% of cases. No association was found between glandular involvement and CIN 1 (P > 0.05); however, there was an association with CIN 2 and CIN 3 (P < 0.05).
  
  
  CONCLUSIONS
  The amount of excised tissue was sufficient, thermal artifacts were slight, resection margins were clear in most of cases, and a possible association was found between glandular involvement and the severity of the lesion.
authors.affiliation: Santa Casa de Misericordia School of Science (EMESCAM), Vitoria, ES, Brazil.
authors.forename: Aristoteles Mauricio
authors.initials: AM
authors.lastname: Garcia Ramos
authors.affiliation: Santa Casa de Misericordia School of Science (EMESCAM), Vitoria, ES, Brazil.
authors.forename: Erika Souza
authors.initials: ES
authors.lastname: Garcia Ramos
authors.affiliation: Espirito Santo Federal University (UFES), Vitoria, ES, Brazil.
authors.forename: Helena Lucia Barroso
authors.initials: HL
authors.lastname: Dos Reis
authors.affiliation: Santa Casa de Misericordia School of Science (EMESCAM), Vitoria, ES, Brazil.
authors.forename: Ricardo Bueno
authors.initials: RB
authors.lastname: de Rezende
keywords: Cervical intraepithelial neoplasia; Colposcopy; Conization; HPV