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PubMedDate not supplied

Contribution of cytology, colposcopy, target biopsy and conization to the early diagnosis of precancerous and cancerous lesions of the cervix uteri.

The study is based on 334 cytologic suspect or positive women observed in the area of Florence. Cytologic diagnoses of dysplasia, carcinoma in situ (CIS), and invasive carcinoma are related to the histologic reports. To the same histologic reports are related the colposcopic aspects. Lastly, diagnoses made by target biopsy are compared with the final diagnoses made by cone biopsy. The 3 diagnostic methods and their diagnostic accuracy are then compared. As regards dysplasia, the diagnostic precision of cytology is 40.2% and for target biopsy in 76.9%. In the diagnosis of CIS, cytology shows a diagnostic accuracy (77.7%) that is a little lower than that of target biopsy (81.7%). In invasive carcinoma, cytology has a good diagnostic precision (88.2%), which becomes 100% if the diagnosis is made by target biopsy. The correlation between colposcopic aspects and histologic reports is not very reliable. We conclude that cytology is a valid test in an extensive mass screening, that colposcopy is essential to execute target biopsy, and that the latter is useful in defining dysplasia and invasive carcinoma diagnoses. On the contrary, in the case of CIS, target biopsy does not greatly increase cytology diagnostic precision.

Biopsy↗
PubMed1975

[Surface scraping and curettage of the cervix - an alternative procedure to conization in patients with positive cytology (author's transl)].

421 patients with positive cytological cervical smears had fractioned surface scraping and curettage of the cervix. The clinical results equaled those of cone biopsy series: in 68,6% the histological diagnosis was exactly the same before and after treatment; in 17,5% there were minimal but clinically unimportant changes in histological assessment; in 10,6% the lesion had been completely removed by scraping and curettage. Thus 407 patients (96,7%) were treated in the same way as if the definitive histological diagnosis would have been known in advance. Only in 5 patients (1,25%) the first step was inadequate retrospectively and further treatment was necessary. Regarding the comparable clinical results the essentially poorer risks and costs favour the surface scraping and endocervical curettage against cone biopsy.

Adult↗
PubMed1975

[Problems in the indication for hysterectomy post conization].

The importance of histo-pathological diagnosis after conisation of the Cervix uteri in view of hysterectomia post conisation is discussed (94 Carcinomata in situ, 53 cases of dysplasia and 13 microcarcinomata). If there is a modern technique of coldknife-conisation, an intensive histo-pathological diagnostic regime and the possibility of cytological and colposcopical control, hysterectomia is not necessary in cases of complete removal of carcinoma in situ by conisation.

Carcinoma in Situ↗
PubMed2004

[Laser conization].

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Blood Loss, Surgical↗
PubMed1992

[The treatment of severe dysplasias by CO2 laser: the respective indications for vaporization and conization. 84 cases].

Fifty-nine conisations and 25 vaporizations were carried out using laser CO2 in order to treat a series of 84 cases of severe dysplasias (CIN III). After a follow-up of 4 and 12 months (median period of observation 25 months) it was found that out of 74 patients that were followed up in this way 72 had benefitted from the use of the treatment. There were 5 cases however of recurrence of dysplasia (1 CIN I, 2 CIN II, 2 CIN III). These had further treatment with laser. Four of those were controlled properly, the fifth had to have surgery. Complications of treatment did not occur when vaporization was used and only rarely when conisation was used. With vaporisation it is not possible to obtain a piece for histological examination, but if it is done according to precise criteria it is safe (7 mm depth at least and vaporisation carried out to 3 mm beyond the lesions). It can be used particularly in young patients who have never been pregnant. If these have been examined carefully with directed biopsies taken colposcopically and where the lesion is strictly limited to the exocervix and the transformation zone has been seen and the lesion is small (2 cm of less), 84% were controlled therapeutically and using Bruhat's criteria the success rate was 96%. Conisation was effective for every one of the other cases. Laser CO2 probably lessens local complications of the procedure and if vaporization is carried out on the rim of the cervix better control of the condition is obtained (98% controlled in the period under review).

Adult↗