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Minerva Ginecologica 2018 August;70(4):364-70

DOI: 10.23736/S0026-4784.18.04196-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Diagnostic accuracy of endocervicoscopy as preoperative tool to improve the excisional treatment of cervical preneoplastic lesions

Pasquale DE FRANCISCIS 1, 2, Viviana LA MANNA 1, 2, Antonio SCHIATTARELLA 1, 2, Domenico AMBROSIO 1, 2, Domenico LABRIOLA 1, 2, Roberto PROCACCIANTI 1, 2, Franco P. AMMATURO 1, 2, Maddalena MORLANDO 1, 2, Marco TORELLA 1, 2

1 Obstetric and Ginecological Center, Department of Woman and Child, University of Campania “Luigi Vanvitelli”, Naples, Italy; 2 Obstetric and Ginecological Center, Department of General and Specialistic Center, University of Campania “Luigi Vanvitelli”, Naples, Italy


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BACKGROUND: The aim of this study was to evaluate the diagnostic accuracy of endocervicoscopy as a preoperative examination to improve the outcome of the excisional treatment (LEEP) of high-grade cervical preneoplastic lesions.
METHODS: Patients with histologic diagnosis of CIN II-CIN III undergoing LEEP divided in two groups: in group A (85 women) a preoperative endocervicoscopy was performed, in group B (85 women) no additional examination was performed before LEEP. The size of the surgical specimen (H, D, W) and the margins of the lesion were evaluated.
RESULTS: Seventy-four women in group A and 80 in group B completed the follow-up. group A showed significant correlation between colposcopic examination and endocervicoscopic examination (P=0.001, k=0.30) and between endocervicoscopic and definitive histological examination (P<0.05, k=0.16). The depth of the operative sample was significantly lower (P<0.0001) in group A (0.91±0.4) than in group B (1.58±0.2), group A showed fewer patients B with positive endocervical margins than group B (3 vs. 17, P<002). Colposcopic, cytological and virological follow-up did not show significant differences between the two groups.
CONCLUSIONS: Endocervicoscopy as preoperative tool for excisional treatment of cervical lesions showed high diagnostic effectiveness and allows to perform a conservative surgery.


KEY WORDS: Colposcopy - Cervical intraepithelial neoplasia - Therapeutics

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