2018, Number 12
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Ginecol Obstet Mex 2018; 86 (12)
Related factors to absence of cervical intraepithelial neoplasia in the conization specimen
Sánchez-Gómez R, González-Benítez C, Ruíz-Martínez T, Alonso-Luque B, Serrano-Velasco M
Language: Spanish
References: 12
Page: 787-793
PDF size: 238.78 Kb.
ABSTRACT
Objectives: to investigate the possible causes of the negative cones, to establish
strategies to reduce their incidence and to develop monitoring protocols.
Materials and Methods: This is a retrospective observational cases and controls
study of 432 conizations made in the Hospital Universitario La Paz (HULP) between
2013 and 2015. The most important analysed variables were the pathological anatomy
of the piece and its relationship with the biopsy and previous cytology, the cone length,
as well as the presence and artefact and cervicitis. The analysis it was used Chi – Square
and Fisher´s test, T-Student, Mann Whitney U, Kruskal-Wallis and Kolmogorov- Smirnov.
Results: There are two groups: 371 positive (85,9%) and 61 negative cones (14,1%).
We find statistically significant differences in the cytology, colposcopy and biopsy preconization,
finding a major percentage of injuries of lesser degree in the patients with
negative cone. The length of the cone was lower in the analysis group and in this we
also observed a greater percentage of cervicitis and artefacts.
Conclusions: The causes that make the remaining injury not appear after a diagnosed
and/or therapeutic conization are a wide variety and difficult to prove. We should
try to treat the patients with inflammation or atrophy to avoid false positives in the
cytology and biopsy, improve the surgical technique to avoid artefacts and perform
conservative management of low-risk injuries.
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