Multiple levels on LLETZ biopsies do not contribute to patient management

Cervical large loop excision of the transformation zone (LLETZ) specimens are performed both to treat and to diagnose or exclude cervical pre-neoplasia. Examination of these specimens forms a significant part of the routine histological work load of the pathologist, yet histological confirmation of...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Pathology Jg. 44; H. 1; S. 7 - 10
Hauptverfasser: Kenwright, Diane, Braam, Greer, Maharaj, Dushyant, Langdana, Fali
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Elsevier B.V 01.01.2012
Schlagworte:
Biopsy
Cervical Intraepithelial Neoplasia - diagnosis
Cervical Intraepithelial Neoplasia - surgery
Cervix
CIN
Female
Follow-Up Studies
HPV
human
Humans
LEEP
LLETZ
Logistic Models
Neoplasm Recurrence, Local
Pathology, Surgical - methods
Retrospective Studies
SIL
Uterine Cervical Dysplasia - diagnosis
Uterine Cervical Dysplasia - surgery
Uterine Cervical Neoplasms - diagnosis
Uterine Cervical Neoplasms - surgery
LEEP
SIL
CIN
LLETZ
Cervix
female
human
HPV
ISSN:0031-3025, 1465-3931, 1465-3931
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:Cervical large loop excision of the transformation zone (LLETZ) specimens are performed both to treat and to diagnose or exclude cervical pre-neoplasia. Examination of these specimens forms a significant part of the routine histological work load of the pathologist, yet histological confirmation of squamous intraepithelial lesion (SIL) or completeness of excision, does not alter the treatment of SIL. When the LLETZ procedure is done, the treatment is complete, the dysplasia having been subject to excision as well as diathermy during the procedure. In this study, records of 1139 women who underwent LLETZ treatment for SIL were examined. The grade of SIL present and the margin status were extracted from histology reports and linked to post-LLETZ follow-up cytology and histology, for a period of 2 years. SIL recurrence in women with high grade (HG-SIL), low grade SIL (LG-SIL) and normal LLETZ biopsy results was not significantly different. There was no significant difference between the recurrence rates of HG-SIL and LG-SIL with SIL at margins compared to SIL clear of margins. Pathologists spend significant time examining multiple levels of LLETZ biopsies, grading SIL, determining margins and trying to find SIL in ‘normal’ LLETZ biopsies. None of this affects the subsequent follow-up. The most useful data the pathologist can provide is whether invasion is present or not. Pathological effort should be directed to examining multiple levels of those with HG-SIL to find invasion, rather than spending time looking at multiple levels of normal or LG-SIL LLETZ biopsies.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0031-3025
1465-3931
1465-3931
DOI:10.1097/PAT.0b013e32834d7b5d