Loop Electrosurgical Excision Procedure (LEEP) at Maharaj Nakorn Chiang Mai Hospital : Problems in Pathologic Evaluation
SURAPAN KHUNAMORNPONG, M.D.*, KASEM RAUNGRONGMORAKOT, M.D.**, SUMALEE SIRIAUNKGUL, M.D.*
Affiliation : * Department of Pathology, ** Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Method : The histologic slides of the specimens from 163 patients who underwent LEEP at Maharaj Nakom Chiang Mai Hospital from August 1995 to November 1997 were retrospec tively reviewed for the degree of thermal artefact and the margin status. Follow-up data after a 6-month-period were correlated with the margin status.
Results : Thermal artefact was present in all cases (mild 51.5%, moderate 36.2%, and severe 12.3%). In only one case, histologic diagnosis of the lesion was not possible due to severe thermal artefact. Nine cases (5.5%) had non-evaluable margins due to either thermal artefact (7 cases) or improper orientation of fragmented tissue (2 cases). Of 90 cases with subsequent surgical specimens, residual diseases were present in 4 of 21 (19.0%) with negative LEEP mar gins, in 31 of 64 (48.4%) with positive margins, and in 4 of 5 (80.0%) with non-evaluable mar gins.
Conclusions : Pathologic evaluation of the specimens from LEEP was limited in only a minority of cases. Thermal artefact was not a critical disadvantage of LEEP. The positive or negative margin status was correlated with the risk of residual disease.
Keywords : LEEP, Uterine Cervix, Thermal Artefact
