Abstract
This retrospective study examined the relationship between loop electrosurgical excision procedure (LEEP) margin status and post-LEEP Pap smear results. LEEP is an established modality for the diagnosis and treatment of cervical intraepithelial neoplasia. LEEP has advantages over destructive and ablative techniques because excised tissue is examined histologically to determine the grade and extent of intraepithelial neoplasia. Though the status of ectocervical and endocervical margins is routinely reported for LEEP operations, controversy exists about the significance of positive margins for the prediction of recurrent disease. We examined the relationship between LEEP margin status and abnormalities on post-LEEP Pap smears. Previously published studies have reported mixed results about the value of positive margin status [1–4]. The study consisted of 129 consecutive female patients undergoing LEEP procedures. Follow-up Pap smear data were available for 106 women. Clinicians with knowledge of margin status performed the Pap smears using cytobrushes. Margin status was determined using all margin information available in reports. Submitted LEEP specimens contained one or more pieces. Additional specimens were sometimes submitted and determined to supercede the margins on the main specimen. Among the 106 patients with post-LEEP follow-up Pap smears, 27.5% were positive for abnormal squamous cells (atypical cells of undetermined significance [ASCUS] and above) at their first satisfactory post-LEEP Pap smear. A significantly higher proportion of first post-LEEP Pap smear results were positive in women with positive ectocervical ⁎ Corresponding author. 2853 Sunset View, Signal Hill, California 90755, USA. Tel.: +1 562 986 1217. E-mail address: Lynn.sandweiss@gmail.com (L. Sandweiss).
Published Version
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