Colposcopy Colposcopically Directed Biopsy and LEEP in the Diagnosis of Cervical Intraepithelial Neoplasia

Objective:To evaluate the clinical value of colposcopy images,colposcopically directed biopsy and cervical loop electrosurgical excision procedure(LEEP) in diagnosis of cervical intraepithelial neoplasia(CIN),and to compare the differences among the three kinds of methods of diagnosing CIN.Methods:LEEP was performed on 232 patients diagnosed as CIN by colposcopy and colposcopically directed biopsy.The consistency of results of diagnosing CIN by colposcopy,colposcopically directed biopsy and LEEP was evaluated.Results:The consistence rate of the diagnosis by colposcopy and that by colposcopically directed biopsy was 57.8%(134/232).The diagnosis of 140 out of the 232 patients by colposcopically directed biopsy was consistent with that by LEEP as confirmed by pathologic diagnosis with a consistence rate of 60.3%,including 32 cases of overdiagnosis(13.8%,32/232) and 60 cases of underdiagnosis(25.9%,60/232).The consistence rate of the diagnosis by colposcopically directed biopsy and that by LEEP was 62.9%(146/232),with the overdiagnosis rate 12.1%(28/232) and the underdiagnosis rate 25.0%(58/232).A significant difference between the diagnosis by colposcopically directed biopsy and that by LEEP was found(Wilcoxon test,P=0.017).The sensitivity and specificity of colposcopy in evaluation of CIN Ⅰ was 82.5% and 72.9%,respectively.The specificity of colposcopy in evaluation of CIN Ⅱ and CIN Ⅲ were 82.1% and 85.9%,respectively,whereas the sensitivity was 37.5% and 41.2%,respectively.Conclusions:Colposcopy is an effective assistant method for diagnosing CIN.The accuracy of diagnosing CIN with colposcopically directed biopsy is still unsatisfying.Cervical conization by LEEP can not be instead of colposcopically directed biopsy.It is suggested that LEEP may be a suitabale choice for patients with diagnosis of CIN by colposcopy.