Diagnostic possibilities of the electroexcision and cold knife conization for precancerous lesions of the uterine cervix.

Purpose: The aim of the present study was to assess and compare the diagnostic possibilities of the loop electroexcision procedure (LEEP) and of conventional surgical conization of the uterine cervix in women with cervical precancerous lesions.

Patients And Methods: The study involved 80 women aged between 22 and 63 years (mean age 38.75 years), with cytological findings indicating various degrees of dyscaryosis. The patients were subjected to colposcopic targeted biopsy with subsequent (within 3 months) wide excision (40 patients with LEEP and 40 with cold knife conization).

Results: In both groups of women coincidence of the results to 1 degree of difference was found in 34 (85%) women. Analysis of the results obtained showed no statistically significant difference (p >0.05), both in the cases of full agreement as well as in the cases with 1 degree of difference, between the findings obtained by LEEP and surgical conizations on the one hand, and targeted biopsies on the other hand, as well as between the two excisional procedures. Also, no statistically significant difference between LEEP and surgical conization was found in comparing the frequencies of resection lines in healthy tissues and in the cases with visible squamous/ columnar junction (p= 0.418). At the same time, such a difference was found in comparing the cases with invisible junction (p= 0.0003), which was due to the cases with positive edges after LEEP.

Conclusion: The results of the present study have evidenced the good possibilities of the LEEP and surgical conization as precision diagnostic tools in precancerous lesions of the uterine cervix. Based on the results obtained we think that LEEP has advantages in lower-grade lesions with visible boundary between squamous and columnar epithelium. In all other cases the method of choice should be surgical conization.