Correlation between Colposcopically Directed Biopsy and Large Loop Excision of the Transformation Zone and Influence of Age on the Outcome
Sathone Boonlikit MD*, Suvanna Asavapiriyanont MD*, Pojanee Junghuttakarnsatit MD*, Suphet Tuipae MD*, Wisit Supakarapongkul MD*
Affiliation : * Department of Obstetrics and Gynecology, Rajavithi Hospital
Objectives : To assess the accuracy and correlation between Colposcopically Directed Biopsy (CDB) and
Large Loop Excision of the Transformation Zone (LLETZ) and the influence of age.
Materials and Methods : A comparative analysis was conducted from the 352 women referred to Rajavithi
Hospital from January 1998 to December 2003, to compare between CDB and LLETZ. Correlation was
assessed by the percentage of concordance (accuracy), Spearman’s rank correlation coefficient (r) and Kappa
statistics (K). A subgroup analysis was performed in women aged ≥ 50 years to evaluate the influence of age
on the correlation.
Results : A 66.2% concordance was found between CDB and LLETZ. The correlation and agreement between
the two procedures were low (r = 0.32, p < 0.0001; K = 0.24, p < 0.0001). In women aged ≥ 50 years, the accuracy
was 60.7% and stronger correlation and agreement were noted (r = 0.50, p < 0.0001; K = 0.31, p = 0.001).
Conclusion : CDB is an inadequate diagnosis tool for Squamous Intraepithelial Lesion (SIL) in woman below
50 years of age. In women aged 50 years or more with satisfactory colposcopy, the accuracy and correlation
between two procedures are not compromised.
Keywords : LLETZ, Correlation, Colposcopically directed biopsy
