Evaluation of colposcopy and LEEP results performed in gynecology and gynecological oncology surgery services

Abstract

The diagnostic performances of colposcopy and Loop Electrosurgical Excision Proce-dure (LEEP) results in gynecology and gynecological oncology surgical services were evaluated. Their differences regarding biopsy numbers were investigated. The other objective was to examine factors associated with recurrence and residual lesions after LEEP. This study included the cytology results of 1217 women undergone colposcopy at our hospital colposcopy unit between 2012 and 2017. The colposcopicsensitivity, specificity, positive predictive value and negative predictive value were calculated based on LEEP results. The qualitative data were compared by employing Chi-square and Fisher’s exact tests. χ2 predicted the relation between age and number of involved margins with recurrent disease. Moreover, it predicted the link between age, cytology and number of relevant margins with residual disease. There was no significant difference regarding the diagnostic performance of two groups when LEEP was determined as the gold standard against colposcopy. The diagnostic accuracy rate was 1.83 times higher when more than 2 biopsies were taken compared to 2 or fewer. A significant increase was observed in the residual rate among women having pre-LEEP high-risk human papillomavirus (HR-HPV) positive tests compared to those with HR-HPV negative tests (48.0% vs. 15.4%, p = 0.04). Women with ≥ High grade squamous intraepithelial lesion (HSIL)-positive margins in the first conization exhibited higher residual rates compared to those with High grade squamous intraepithelial lesion (LSIL)-positive margins (50.7% vs. 9.5%, p < 0.001). Patients ofpositive surgical margins, residual lesions and cervical intraepithelial neoplasia (CIN) with HPV 16 had higher probability of persistent HPV infection after conization. There was no significant difference pertaining to the diagnostic performance of two groups. HPV 16+ and the positive surgical margin were the predictive of recurrence.