Cervical biopsy and excision procedure specimens lack sufficient predictive value for lymph-vascular space invasion seen at hysterectomy for cervical cancer

Am J Obstet Gynecol. 2008 Aug;199(2):151.e1-4. doi: 10.1016/j.ajog.2008.02.017.


Objective: The purpose of this study was to determine whether lymph-vascular space invasion (LVSI) that is discovered in cervical biopsy and excision specimens is associated with LVSI in the hysterectomy specimen of patients with cervical cancer.

Study design: A retrospective pathologic review to determine the presence of LVSI in cervical biopsy specimens, cold-knife cone biopsy (CKC biopsy), and loop electrical excision procedure (LEEP) specimens that contained cervical cancer was performed if subsequent hysterectomy results were available for review. Data were analyzed with chi-square analysis testing.

Results: One hundred six patients were identified. The negative predictive value of the biopsy is lower at 0.45 than either the CKC biopsy (0.83) or LEEP (0.57); however, the positive predictive value (0.83) is higher than either CKC biopsy (0.50) or LEEP (0.75). LVSI, when present in cervical biopsy (odds ratio, 4.13; 95% CI, 0.414-98.446), CKC biopsy (odds ratio, 4.8; 95% CI, 0.542-46.280), and LEEP (odds ratio, 4.0; 95% CI, 0.439-43.793) specimens, is associated with a statistically insignificant increased risk of LVSI in the hysterectomy specimen.

Conclusion: Cervical biopsy and excision specimens lack sufficient negative predictive value for the detection of LVSI in the hysterectomy specimen.

MeSH terms

  • Biopsy, Needle
  • Blood Vessels / pathology
  • Cervix Uteri / pathology*
  • Chi-Square Distribution
  • Female
  • Humans
  • Hysterectomy
  • Lymph Nodes / pathology*
  • Lymphatic Metastasis
  • Neoplasm Invasiveness
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Tissue and Organ Harvesting
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery