Evaluation of cervical conization in diagnosis and management of cervical intraepithelial neoplasia

Objective To determine whether cervical conization can be instead of colposcopic multiple biopsies and to evaluate the clinical value of cervical conization in diagnosis and management of cervical intraepithelial neoplasia. Methods Fifty four patients with cervical intraepithelial neoplasia (CIN) diagnosed and treated at Peking Union Medical College hospital were retrospectively analyzed focusing on the comparative study in pathology between cerical conization and colposcopic multiple biopsies. Results Of the 54 patients, there was a correlation in pathology between cervical conization and colposcopic multiple biopsies in 22 cases (40 7%), but there was not much correspondence between cervical conization and colposcopic multiple biopsies in 32 cases (59 3%). In 31 cases conization performed for ruling out invasive cancer, there was a correlation in pathology between cervical conization and colposcopic multiple biopsies in only 13 cases (41 9%). After conization radical hysterectomy was performed in 2 cases (3 7%) because of early invasive carcinoma and simple hysterectomy was performed in 13 cases (24 1%) because of CINⅢ involved the gland and microinvasive carcinoma of the cervix. 39 cases (73 2%) were closely followed up postoperatively with preservation of fertility. During the mean follow up time of 18 3 months, no cytology abnormality was detected and 3 patients had pregnancy and delivery. Postoperative hemorrhage was main side effect for conization. Conclusions Cervical conization plays a very important role in diagnosis and treatment of CIN and it can not be instead of colposcopic multiple biopsies. Cervical conization is a good choice for patient with CINⅢ and desired childbearing.