DOES THE LOOP ELECTROSURGICAL EXCISION PROCEDURE ADVERSELY AFFECT THEHISTOPATHOLOGICAL INTERPRETATION OF CERVICAL CONIZATION SPECIMENS

Objective, To assess the suitability of conized specimens obtained by loop electrosurgical excision procedure for histopathological interpre tation. Methods. We evaluated the histological pictures of 215 tissue sections obtained by loop electrosurgical excision procedure. These se ctions came from 32 cases of patients with various degrees of cervical intraepithelial neoplasia. All women included in our study had a sati sfactory colposcopy and no cytological or colposcopic evidence of inva sive cancer. We quantified the thickness of thermal damage in the tiss ue sections using a stage-mounted, calibrated grid microscope. Results , At its greatest extent, thermal damage occurring next to incision li nes ranged from 160 to 520 mu (mean 262, SE 14 mu). Two different zone s of thermal damage were produced by LEEP: the carbonization and coagu lation zones. The carbonization zone was located at the outermost laye r and was very thin, measuring from 10 to 30 mu in depth. The coagulat ion zone was adjacent to the carbonization zone, was eosinophilic, and was significantly deeper than the carbonization zone at its points of greatest thickness (150 to 500 mu; p<0.0001, Student's t-test). The d epth of the coagulation zone correlated significantly with the depth o f the carbonization zone (p=0.041, least linear correlation). Tissue d istortion was present in 53% (17/32) of the cases, and appeared only i n the coagulation zone. Conclusion. Tissue structure from the diseased portions of thee conized specimens was generally well preserved. The area of thermal damage was limited and thus did not result in diagnost ic problems. We conclude that LEEP is a reliable method for obtaining tissue samples for histopathological examination.