[Diagnosis and treatment of cervical dysplasia. Report of 42 cases].

The authors present a retrospective study of 42 cases of conization carried out between January 1987 and October 1989 in the Department of Gynaecology 1 of Dupuytren University Hospital in Limoges. The average age of the population was 42 years and 7 months, with an average parity of 1.9 children per woman. Conization was carried out using either a cold knife (37 cases) or an electric knife (5 cases). Complications consisted of 4 stenoses, 2 secondary haemorrhages and 1 perineal burn. 4 microinvasive cancers, 7 CIN III, 10 CIN II, 4 CIN I and 3 pieces of tissue free from any dysplastic lesion were found on histological examination of the conization tissue. 17 patients (40.4%) had flat condylomas. There was perfect agreement between the diagnoses from the smears and biopsies in 82.1 p. cent of cases; there was 57.1 p. cent agreement when the smear result was compared with the histological study of the conization tissue, and 39.2 p. cent agreement when the latter was compared with biopsy results. On the other hand, false diagnosis due to overevaluation of the severity of the dysplasia was predominant using the least invasive examination (42.8 p. cent when comparing the smear results with those from the study of conization tissue, and 39.2% for biopsies with respect to the conizations). According to the authors, the therapeutic strategy to be used in treating dysplasia must take the severity of the dysplasia, the presence of infection due to HPV and its serotyping, the location and size of the dysplasia, the visibility of the endo-exocol junction line and the psychological context of the patient into consideration.