Comparison of three morphological diagnostic methods for patients with cervical intraepithelial neoplasia

Objective To compare the results of three morphological diagnostic methods for patients with cervical intraepithelial neoplasia,including cytological test(liquid-based thin preparation cytology test,TCT)、cervical biopsy under colposcopy and loop electrosurgical excision procedure(LEEP).Methods During March 2005 to April 2007,a total of 6 651 women in our department were screened by cytological tests and patients with abnormal cytological findings were further biopsied under colposcope.Results Among investigated patients,208 patients were diagnosed with atypical squamous cell of undetermined significance(ASCUS),4 patients were of atypical squamous cells(can not exclude high grade SIL)(ASC-H) and 68 patients were found to be low-grade squamous intraepithelial lesion(LSIL),13 patients of high-grade squamous intraepithelial lesion(HSIL) and 3 cases with cervical carcinoma were detected by TCT including 2 squamouse cell carcinoma and 1 adenocarcinoma.Four hundred and forty-three patients were tested by cervical biopsy under colposcopy,in which 273 cases were abnormal including 105 cases with CIN Ⅰ,42 with CIN Ⅱ,20 with CIN Ⅲ and 8 with infiltrating carcinoma.In comparison with the results of low-grade CIN、high-grade CIN and cervical carcinoma by biopsy,the agreement rate of TCT and colposcope was 50.75%、92.31% and 100%,respectively.A total of 162 cases were treated by conization of LEEP,in which 39 patients were diagnosed with CIN Ⅰ,20 with CIN Ⅱ and 17 with CIN Ⅲ by histopathology.The coincidence of LEEP and colposcope:for CIN Ⅰ was 58.19%,for CIN Ⅱ was 48.00% and for CIN was 61.90%,respectively.Conclusion Despite of the success of three morphological methods,precise diagnosis of CIN is still difficult and has high rate of mis diagnosis and low diagnostic accordance rate.So the diagnosis of CIN cannot depend on morphological methods only.