The role of performing a routine four-quadrant cervical biopsy in patients with negative colposcopic findings in increasing the identification rate of cervical intraepithelial neoplasms

Abstract

Aim: In patients with high-risk human papilloma virus (HPV), there is no consensus on the inclusion of cervical biopsy for diagnostic purposes in cases whereas there is no pathological finding in colposcopy. In this study, we aimed to investigate the effect of simultaneous routine cervical biopsy in patients with normal colposcopic findings on the rate of cervical intraepithelial neoplasia diagnosis.

Methods: This retrospective study included 119 patients with colposcopy indications who had no cervical pathology between January 2015 and March 2017 and the histopathological results were evaluated.

Results: The mean age of the population was 45.75±9.52 years. The histopathological results obtained in our study patients are as follows; 38.7% (n=46) LSIL, 28.7% (n=33) chronic cervicitis, 15, 3 % (n=19) coilositosis, 9.2% (n=11) HSIL, 2.5% (n=5) adenocarcinoma, 1.7% (n=2) carcinoma in situ and 2.1% (n=3) squamous carcinoma. LSIL 33 (27.5%), HSIL and advanced lesion 11 (9.2%) were detected in patients with normal cervical cytology before colposcopy. LSIL 26 (21.7%), HSIL and advanced lesion were found to be 13 (10.8%) in patients with abnormal cervical cytology. There was no significant difference in terms of biopsy pathology results between normal and non-normal cervical cytology results.

Conclusions: In patients with HPV positive and normal colposcopic findings, adding simultaneous routine four-quadrant cervical biopsy to the colposcopy might increase the detection rate of cervical intraepithelial lesions.