Colposcopic Cervical Biopsy And Rapid Pathological Examination Of Cervical Conization In The Diagnosis Of Cervical Intraepithelial Neoplasia

Purpose:To investigate the diagnostic value of rapid pathological examination of cervical biopsy and cervical conization for cervical intraepithelial neoplasia(CIN).Comparative analysis of the difference in the detection rate of CIN in colposcopy cervical biopsy and rapid pathological examination in cervical conization.Materials and methods:Retrospective analysis of 682 patients who underwent colposcopic biopsy and were diagnosed with CIN during the gynecological hospitalization of Shandong Provincial Hospital from January 2011 to December 2016.The age ranged from 22 to 73 years,with an average age of 38.5 years.There were 33 cases of low-grade intraepithelial neoplasia(LSIL),619 cases of high-grade intraepithelial neoplasia(HSIL),and 30 cases of early cervical invasive carcinoma.All patients were treated with cervical conization surgery.According to different surgical methods,LEEP conization(405 cases)and cold knife conization(277 cases)were divided into two groups.The clinical value of colposcopy biopsy pathological examination,intraoperative rapid pathological examination and postoperative paraffin pathological examination were compared.The clinical value of colposcopic cervical biopsy and intraoperative rapid pathological examination in the treatment of cervical intraepithelial neoplasia was evaluated.To investigate whether there is a difference in the results of rapid pathological examination during LEEP conization and cold knife conization.Result:1.In this study,the consistency of preoperative colposcopic cervical biopsy pathology and postoperative paraffin pathology was 79.18%(540/682),and 17 cases of early invasive cervical invasive carcinoma were missed,accounting for 2.49%of the total.The detection rate of pathological findings of cervical biopsy under colposcopy was lower than that of postoperative paraffin,P=0.038(P<0.05),the difference was statistically significant.2.The consistency of rapid pathology and postoperative paraffin pathological diagnosis of cervical conization was 90.97%(574/631).The rapid pathological detection rate was lower than postoperative paraffin pathology,but the difference was not statistically significant.Kappa consistency was performed.Test,kappa=0.779(P>0.05),suggesting that the two are in good agreement.3.The residual rate of margin lesions in cervical conization was 8.08%(51/631).The rapid accuracy of pathological assessment of residual lesions in cervical conization was 97.62%(616/631),and the sensitivity was 80.39%.(41/51),the specificity was 99.14%(575/580),P=0.302(P>0.05).There was no significant difference between the rapid pathology and the postoperative paraffin pathology.There was no significant difference in the detection rate between the frozen pathology and the cold knife conization group in the LEEP group,P=0.082P(P>0.05).Conclusion:Colposcopy cervical biopsy has a certain value in the diagnosis of cervical intraepithelial neoplasia,but there are certain misdiagnosis and missed diagnosis.Intraoperative rapid pathological examination has a high accuracy rate in the diagnosis of conical CIN lesions,especially the determination of the margin of the margin,which has important clinical significance for guiding the scope of surgical resection.Cervical LEEP combined with frozen pathological examination can be the first choice for diagnosis and treatment of patients with cervical intraepithelial neoplasia.