Cyto-reversion rates following large loop excision of the transformation zone on high-grade liquid based cytology.

Jackie Fellows, Cellular Pathology

Background:  Each year in the United Kingdom approximately 2,800 women are diagnosed with cervical cancer, and is the second most common cancer in women under 35 years old.

Approximately four million women each year are invited for cervical screening between the ages of 25-64 every three to five years. The aim of cervical screening is to detect any pre cancerous cells of the cervix and remove them before progression to an invasive disease and cancer.

Large loop excision of the transformation zone (LLETZ) is the main technique used for the outpatient treatment of cervical intraepithelial neoplasia (CIN), and is regarded as the gold standard treatment.  One of the main advantages of LLETZ is the availability of the excised specimen for histological diagnosis.

Aim: To identify the number of patients with recurrent high grade dyskaryosis (cyto reversion rate) in follow up smears post treatment.

The benefits gained may help both the screening and colposcopy department in the future management of patients with recurrent high grade CIN if any trends/patterns emerge once the results are analysed.

Method: The colposcopy database will be used to review approximately 400 cases with incomplete excision at the endocervical margin, and those with extensive CIN 3 on histology samples during the period January 2002 - November 2007. Cases identified will be assessed with regard to any subsequent recurrent CIN and the correlation between complete and incomplete excision margins.