The appropriateness of examining the entire cervix histologically in hysterectomy specimens from women with a previous history of cervical intraepithelial neoplasia or dyskaryosis

BACKGROUND/AIMS: To investigate the necessity of examining the entire cervix in hysterectomy specimens from women with a previous history of cervical intraepithelial neoplasia (CIN) or dyskaryosis. METHODS: The overall frequency with which squamous CIN was encountered in hysterectomy specimens of women with a previous diagnosis of squamous CIN or dyskaryosis was calculated in a sample of 71 women. The frequencies in women with positive or negative smears or biopsies between the initial diagnosis and hysterectomy, and in women with no intervening smear or biopsy, were also estimated. RESULTS: A persistent CIN lesion was identified in 18 patients (13 high grade cases; five low grade cases). A further eight patients who had high grade CIN also had microinvasive disease (seven cases of FIGO stage 1a1; one case of FIGO stage 1a2). Ten of the 20 patients with a positive smear or biopsy, but none of the 16 patients with a negative smear or biopsy between initial diagnosis and hysterectomy, had an abnormality on the hysterectomy specimen. Sixteen of the 35 patients who did not have an interim smear or biopsy had CIN in the hysterectomy cervix. CONCLUSIONS: These results support continuing the practice of examining the entire cervix in hysterectomy specimens from women with a previous cervical abnormality, regardless of its histological or cytological grade, if there has been a positive interim smear or biopsy or if neither investigation has been performed.