Prognostic factors for low- and high grade squamous intraepithelial lesions in histological preparations following LLETZ procedure.

Abstract

Objective: Aim: To investigate the influence of the following prognostic factors: age, parity, hormonal status (premenopausal, postmenopausal), histological result from targeted biopsy (LSIL, HSIL), adequacy of colposcopic examination (satisfactory, unsatisfactory colposcopy), type of TZ (type 1, 2, 3), type of cervical lesions (type 1, 2, 3), the colposcopic impression (diagnosis) of the cervical lesion (LSIL, HSIL/Ca colli uteri in situ), lesion size (up to 1/3; up to 2/3; more than 2/3 of the cervical circumference) for the occurrence of LSIL and HSIL/Ca colli uteri in situ in the final histological result after LLETZ procedure.

Patients and methods: Materials and Methods: This is a prospective study (01.01.2017 - 31.07. 2021) including 189 patients with cervical precancerous lesions received LLETZ treatment One gynaecologic oncologist performed video colposcopy, targeted biopsy, and LLETZ. One histopathologist diagnosed histological specimens from the biopsy and LLETZ procedure.

Results: Results: We found a statistically significant correlation between the histological result of the targeted biopsy factor and the colposcopic diagnosis factor concerning the final histological result of LLETZ. The cervical lesion size factor and cervical lesion type factor have prognostic significance for the histological outcome following LLETZ.

Conclusion: Conclusions: The histological result of targeted biopsy and colposcopic diagnosis are significant factors for the final histological result after LLETZ. Cervical lesion invasion into the endocervical canal is a prognostic factor for HSIL, and its invisible borders - for carcinoma (in situ or microinvasive/invasive). Lesion size up to 1/3 of the cervix is a prognostic factor for LSIL and large lesions (2/3 of the cervix) - for HSIL and cervical cancer (in situ, microinvasive/invasive).