Analysis of Pathological Discrepancies Between Colposcopic Biopsy and Conization in Cytology-Positive Cervical Lesions.
Colposcopic biopsy and conization diagnoses agreed in fewer than half of cases
Analysis of Pathological Discrepancies Between Colposcopic Biopsy and Conization in Cytology-Positive Cervical Lesions.
To investigate factors contributing to discrepancies between colposcopic-directed biopsy (colposcopic-directed biopsy) and conization in patients with cytology-positive cervical lesions to reduce missed diagnoses of cervical cancer and unnecessary conizations.
A retrospective analysis was conducted, including 1407 patients with positive ThinPrep cytologic test (ThinPrep cytologic test) results who underwent both colposcopic-directed biopsy and cervical conization (loop electrosurgical excision procedure and cold knife conization), selected from a cohort of 200,814 screened individuals (January 2020-April 2025).
McNemar's test revealed a significant discrepancy between the diagnosis of HSIL+ by colposcopic-directed biopsy and post-conization (p < 0.01).
Specifically, downgrading was more likely in patients < 35 years of age, with ThinPrep cytologic test results showing ASC-US, LSIL, or ASC-H, no evidence of glandular involvement, a biopsy-to-conization interval < 90 days, and transformation zone 1.
Significant pathological discrepancies exist between colposcopic-directed biopsy and conization, and clinicians should consider these factors to create more precise and individualized treatment strategies.