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Original ArticleOpen Access
Loop Electrosurgical Excision Procedure (LEEP) at Maharaj Nakorn Chiang Mai Hospital : Problems in Pathologic Evaluation
Khunamornpong S 
,
Raungrongmorakot K ,
Siriaunkgul S
,
Raungrongmorakot K ,
Siriaunkgul S Background : Loop electrosurgical excision procedure (LEEP) is widely used in diag-
nosis and management of cervical lesions. Difficulties in histopathologic evaluation of LEEP
specimens, particularly for the margin status, have been reported to be a significant disadvantage
of the procedure.
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.
Key word : LEEP, Uterine Cervix, Thermal Artefact
nosis and management of cervical lesions. Difficulties in histopathologic evaluation of LEEP
specimens, particularly for the margin status, have been reported to be a significant disadvantage
of the procedure.
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.
Key word : LEEP, Uterine Cervix, Thermal Artefact
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