Large loop excision of the transformation zone (LLETZ): a pathology evaluation in the Limpopo province, South Africa

  • Louis-Jacques Jean van Bogaert National Health Laboratory Service
Keywords: cervix, high-grade intraepithelial lesion, large loop excision of the transformation zone


Objective: To evaluate the cytological and histopathological concordance in large loop excision of the transformation zone (LLETZ) specimens, and the outcomes according to the characteristics of the excision margins. Method: A prospective observational study of 413 consecutive cases of LLETZ performed for cytologically diagnosed high-grade squamous intraepithelial lesion (HGSIL)/cervical intraepithelial neoplasia (CIN) 2-3 over a three-year period. Results: The discordance rate between the initial cytological diagnosis and biopsy-proven HGSIL was 24.5%. The overall rate of margins believed to be clear and of severe thermal artefacts was 30.4% and 7.4% respectively. Pathology follow-up was available only in 83 (26.5%) of the 313 biopsy-confirmed HGSIL. The persistence or recurrence rate was 78.0%; 90.5% occurred among the cases where the margins were believed to be involved. In 20.5% the reported marginal status was discordant with follow-up surgical pathology. Conclusion: Reporting marginal status has limited prognostic significance.

Author Biography

Louis-Jacques Jean van Bogaert, National Health Laboratory Service
MD, MMed (Obstet Gynaecol), MMed (Anat Path), MPhil, DPhil, PhD Department of Anatomical Pathology National Health Laboratory Service and University of Limpopo Polokwane South Africa
Original Research