A Clinical Study of Correlation between Colposcopy Directed Punch Biopsy and Leep (Loop Electrosurgical Excision Procedure) in Cervical Intraepithelial Neoplasia

Cervical cancer is a preventable disease. It is also curable if detected early and adequately treated. Yet it is the fourth most common cancer among women globally.In India cervical cancer is the second most common cancer among women between 15 and 44 years of age. The most common histologic type of cervical cancer is squamous, most common causeis by HPV infection. Cervical intraepithelial neoplasia (CIN) is a premalignant condition of the uterine cervix. Various screening methods are available for diagnosis including Pap smear and colposcopic directed biopsy. However, LEEP (Loop electrosurgical excision procedure) is used for treatment of CIN. Invasive cervical cancer has a long pre invasive phase and hence early diagnosis and treatment can be done. Objective: This is a prospective observational study of correlation between colposcopic directed biopsy and LEEP in cervical intraepithelial neoplasia (CIN). Methods: A longitudinal study was conducted on 150 subjects attending Gynecological Outpatient department at tertiary care centre and who met the inclusion and exclusion criteria of reproductive age group i.e.(22-55 years) those were screened for CIN (cervical intraepithelial neoplasia) by VIA(visual inspection via acetic acid) and/or cervical cytology by liquid based cytology. All the patients with positive VIA and abnormal cervical cytology findings were subjected /screened by colposcopy examination and patients with CIN were subjected to LEEP. Kappa statistics was used to determine agreement between 2 test procedure. Spearman?s correlation coefficient (rho) was used to measure strength and direction of association between 2 test procedure based on ordered variables. P value less than0.05 was considered statistically significant. Results: 111 patients were having cervicitis on colposcopy directed biopsy and 39 patients were diagnosed with CIN. The colposcopy directed biopsy and LEEP results were statistically significant in positive patients with CIN. No significant correlation between demographic indices and prevalence was noted in CIN patients. Conclusion: Colposcopic directed biopsy is the gold standard for diagnosis as confirmed by Loop electrosurgical excision procedure (LEEP), also known as large loop excision of the transformation zone (LLETZ), a method used for excisional treatment of HSIL.