Quality of tissue from punch biopsy forceps vs. round loop electrode in colposcopically directed biopsy: a randomized controlled trial

Abstract

ObjectiveTo compare the quality of tissue from punch biopsy forceps (PB group) with round loop electrode (LE group) in colposcopically directed biopsy along with the evaluation of pain associated with each procedure.MethodsPatients with abnormal cervical cytologic results and abnormal colposcopic findings were enrolled into a randomized trial into either a PB group or LE group. The quality of tissue was evaluated in regards to the size of tissue, site of tissue, and tissue damage. Each quality had 1 to 3 points and the sum of each quality contributed to the total tissue score that ranged from 3 to 9. Pain associated with each procedure was assessed by a visual analog scale (VAS). This was a clinical trial study and was registered at www.clinicaltrials.in.th (Identifier: TCTR20160404001).ResultsNinety-six women who met all eligibility requirements were enrolled in the study. Forty-eight patients were randomly assigned to the PB group and 48 patients were randomized into the LE group. The characteristics of the patients were similar between the 2 groups with the exception of the median age. The median total tissue score was 8 points in the LE group which was more than the median of 7 points in the PB group with a statistically significant difference (p=0.014). However, the median VAS pain score in both groups was 3.4 (p=0.82).ConclusionThe quality of cervical tissues obtained from biopsy with a round loop electrode was better than the punch biopsy forceps with no difference in the level of pain.

Quality Assessment of Endoscopic Forceps Biopsy Samples under Magnifying Narrow Band Imaging for Histological Diagnosis of Cervical Intraepithelial Neoplasia: A Feasibility Study

“…This is similar to the cut-off value of 1.7 mm for the size of evaluable specimen in the present study. Although larger biopsy samples are reported to have better diagnostic accuracy than small samples [ 14 ], the diagnostic goal of colposcopy is the precise identification of CIN, and targeted P-Bx is necessary for accurate histological diagnosis [ 15 ]. Accordingly, larger specimens obtained by invasive P-Bx may not be mandatory for CIN diagnosis, thus less invasive techniques and devices must be developed [ 16 ].…”