Significance of punch biopsy and endocervical curretage in diagnostics of cervical intraepithelial lesions

Abstract

Diagnostic procedures during the detection of cervical intraepithelial lesions (CIN) are a combination of cytology, colposcopy, punch biopsy and endocervical curretage. An optimal therapeutic approach according to the distribution, size and grade of cervical lesions is the result of this diagnostic protocol. This study was carried out to assess reliability of the punch biopsy and endocervical curretage in diagnostics of cervical intra-epithelial lesions. Fifty patients undergoing cervical conization were studied retrospectively to evaluate the correlation between the grade of preoperative punch biopsy and endocervical curretage, and the grade of the dysplastic epithelial changes in the cone biopsy. CIN grade was established according to the WHO/ISGYP classification and comparation of the results was performed after that. Out of the total number of patient, 89.36% of them with dysplastic epithelial changes on cone biopsy had also dysplastic changes in the preoperative punch biopsy. An exact correlation between CIN grades was identified in 56% of the cases, 20% in CIN2, and 36% in CIN3 cases. There were 24.14% patients with negative endocervical curretage, while only in one case the cone biopsy was negative, too. Among the remaining 22 patients with CIN changes in endocervical curretage specimens, only one had a negative cone biopsy. An exact correlation of CIN grade was identified in 37.93% of the cases, 13.79% of CIN2, and 24.14% of the CIN3 cases. There was a positive cor relation between the CIN grades in punch and cone biopsy, as well as between the grade on the endocervical curretage and cone biopsy specimen, but with the lower degree than previous.