OBJECTIVETo explore the optimal diagnosis and treatment methods for grade III cervical intraepithelial neoplasia (CINIII).

METHODSNinety-eight cases of CINIII initially diagnosed by colposcopical biopsy in our hospital from 2000 to 2008 were analyzed retrospectively in terms of the diagnosis, treatment and outcome.

RESULTSAll the patients received cervical conization including 53 with cold knife conization and 45 with LEEP conization. Obvious differences were noted between cervical conization and colposcopical biopsy results in 15 cases (15.3%) diagnosed to be invasive carcinoma. Fifty-two patients received hysterectomy after conization. A significant difference occurred in pathological diagnosis between cervical conization and hysterectomy groups (P<0.01). There were low-grade cervical intraepithelial lesions in most cases of hysterectomy group and only 4 cases had CINIII. Thirty-one patients refused hysterectomy for concerns of fertility or because of a young age and were followed up after conization. One patient with cervical carcinoma in situ experienced recurrence in 3 years and received a second hysterectomy. The other patients including those in hysterectomy group showed no recurrence till now.

CONCLUSIONCervical conization is the golden standard for the diagnosis of CINIII and can not be replaced by colposcopical biopsy. Cervical conization may serve as the primary choice for treatment of CINIII with negative margin, but the patients should be followed up closely after the operation.