Should punch biopsies be used when high-grade disease is suspected at initial colposcopic assessment? A prospective study. Colposcopy Clinic and Pathology Department, University Hospital of North Staffordshire, Stoke-on-Trent, Staffordshire ST4 6QG, United Kingdom. The reliability and applicability of colposcopically directed cervical punch biopsy was assessed in a sample of 170 paired punch and large loop excision of cervical transformation zone (LLETZ) specimens obtained from previously untreated women who had been selected for treatment on the basis of cytology and/or colposcopic findings and in whom the entire cervical transformation zone was visible. A single punch biopsy was taken immediately before the LLETZ, and all the specimens were reviewed by a single pathologist. Nine (5.3%) punch biopsies were inadequate. In terms of whether or not there was cervical intraepithelial neoplasia (CIN), the chance-corrected kappa analysis rated overall agreement as poor (kappa = 0.21, 95% confidence limits 0.02-0.39), whereas in terms of histologic grade, it was fair to moderate (kappa = 0.32, 95% confidence limits 0.23-0.42). Punch biopsy tended to underestimate the disease. The sensitivity and specificity of colposcopically directed punch biopsy for the detection of high-grade CIN was 74% and 91%, respectively, with positive- and negative predictive values of 97% and 48%, respectively. Two microinvasive and two intraepithelial glandular lesions were missed on punch biopsy. Punch biopsy should be avoided when high-grade disease is suspected.
Please click on the required question. Thank
you for choosing to visit us. This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT. I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
- Introduction
- Abortion
- Amenorrhoea
- Birth Control
- Bladder Symptoms
- Cancer in Women
- Childbirth
- Children and Teenagers
- Diet / Weight Loss
- Dysmenorrhoea
- Endometriosis
- Fibroids
- HRT
- Hirsutism
- Hysterectomy
- Infections
- Infertility
- Medication Drugs
- Menopause
- Menorrhagia
- Miscarriage
- Painful Sex
- Pap Smear Test
- The Cervix
- Cervical Polyps
- Cervical Erosion
- Cervical Ectropion
- Transformation Zone
- Paptest / Cervical Smear
- Premalignant Cells
- Borderline Smear Result
- Inflammatory Smear Result
- Dyskaryosis / Dysplasia / CIN
- Symptoms and Premalignancy
- Benign and Malignant Tumors
- Cause of Premalignant Smear
- Colposcopy
- Treating Premalignant Cervix
- Curing Premalignant Cervix
- Preventing Recurrence
- Preventing Cervical Cancer
- HPV Screening
- Support Groups - Premalignancy
- Cervical Cancer
- PCOS
- Pelvic Pain
- PMS
- Postpartum
- Pregnancy
- Self Esteem
- Sexual Problems
- Vaginal Discharge
- Vaginal Prolapse
- Vulval Symptoms
Underperforming Family Website?
Visit
KeywordSEOPro.com - SEO Keyword Tool & SEO Tips
Now
Promote Your
Family Website
Improve Your Business Income
