Fan A, et al. - Here, researchers compared the histological results of colposcopically directed biopsy (CDB) with those of cone specimens and aimed to ascertain clinical factors related to the exactness of CDB in characterizing the extent and severity of cervical intraepithelial neoplasia. According to the outcome obtained, old age (≥50), postmenopausal status, and transformation zone type 3 might be positively connected with the under-diagnosis of CDB. They also noted that three or more biopsies and cone width ≥21 mm might improve CDB accuracy. Although, cone width was the only independent factor correlated with CDB accuracy.

Methods

• From September 2012 to December 2016, they studied total 513 patients diagnosed with cervical intraepithelial neoplasia by CDB who underwent conization.
• In this study, they retrospectively assessed the agreement between histological results on biopsies and cone specimens and investigated factors affecting the accuracy of the results.

Results

• They observed that the overall agreement between the histological results on biopsy and the corresponding cone specimens was 74.1%; underestimation occurred in 6.4% of cases.
• In this study, the agreement between histological results on biopsy and cone specimen was 54.5% for low-grade lesions, 78.2% for high-grade lesions, and 28.9% for microinvasive cervical cancer.
• The overall agreement between high-grade cytology and the final histological diagnosis was 86.7%.
• By univariate analysis, patient age (p = 0.026), menopausal status (p = 0.018), type of transformation zone (p = 0.003), number of biopsies (p = 0.002), and cone width (p = 0.015) were observed to be related to the accuracy of CDB.
• However, multivariate logistic regression uncovered that cone width (p = 0.044) was the only independent factor correlated with CDB accuracy.