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Korean Journal of Obstetrics & Gynecology 1999;42(9):1992-2000.
Published online January 1, 2001.
Diagnostic Accuracy of Cytology, Colposcopically Directed Biopsy and Conization and Predictive Factors for Residual Tumor after Conization in Patients with Cervical Neoplasia.
Ki Cheol Kil, Soo Young Hur, Gui Se Ra Lee, Yong Jae Yang, Jee Hyun Lee, Hee Joong Lee, Sa Jin Kim, Eun Jung Kim, Seung Kyu Song, Sung Eun NamKoong, Soo Pyung Kim
This study was performed to evaluate the diagnostic accuracy of cytology, colposcopically directed biopsy and conization and to analyze predictive factors for residual tumor after conization in patients with cervical neoplasia. METHODS: We reviewed 167 patients who had undergone cytology, colposcopically directed biopsy and conization followed by subsequent hysterectomy depending on their current disease status at the Department of Obstetrics & Gynecology, Catholic University of Korea Medical College, Holy Family Hospital from January, 1993 to August, 1998. The diagnostic accuracy of cytology, colposcopically directed biopsy and conization were investigated. Also, we investigated the significance of the margin status and the presence of HPV which were used to predict residual tumors in hysterectomy specimens after conization. RESULTS: The results of each methods were analyzed with regard to the histopathologic findings of the surgical specimen. The accuracy rates of cytology, and colposcopically directed biopsy were 59.3% (99 of 167) and 71.3% (119 of 167), respectively. After conization, residual tumors were found in 30.1% of subsequent hysterectomized specimens (51 of 167). Underestimation by conization occurred in 2.0% of cases (1 of 51) and overestimation in 7.8% (4 of 51). Residual tumors were significantly more frequent in patients with positive conization margins than in those with negative margins (P<0.001). But the presence of HPV was not significant. CONCLUSION: These results suggest that diagnostic conization seems to be essential procedure in patients showing abnormal results by cytology and colposcopically directed biopsy, especially in those with CIN III or microinvasion, for the further proper management of cervical neoplastic lesion and margin status is useful in predicting residual tumor after conization.
Key Words: Cytology, Colposcopically directed biopsy, Conization, Residual tumor

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