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Objective This study aimed to determine the factors affecting pathologic discrepancy and final diagnosis between colposcopicbiopsy and pathology by loop electrosurgical excision procedure (LEEP). Methods Between 2004 and 2016, 1,200 patients who underwent LEEP were enrolled for this study. 667 underwent cervicalcytology, human papillomavirus (HPV) test, colposcopic biopsy, and LEEP. We analyzed patient's age, menopausalstatus, number of delivery, abortion times, cervical cytology, number of punch biopsies, HPV type, LEEP, and intervalbetween colposcopic biopsy and LEEP. Results Logistic regression analysis of the final diagnosis showed that age 30.39 years and other high HPV group types wereassociated with cancer diagnosis, whereas atypical squamous cells cannot exclude high-grade squamous intraepitheliallesion (ASC-H), high-grade squamous intraepithelial lesion (HSIL), and HPV type 16 affected the diagnosis of cervicalintraepithelial neoplasia (CIN) 2. The overall concordance rate of histopathology between punch biopsy and LEEPwas 43.3%. The rates of detecting a more severe lesion by LEEP than those by biopsy were 23.1%. The rates of a lesssevere lesion detected by LEEP than those by biopsy were 33.6%. Factors related with biopsy underestimation were asfollows: <1 vaginal delivery, HSIL, number of punch biopsies and HPV type. Punch biopsy number is a unique factor ofbiopsy overestimation. Conclusion Patients with ASC-H, HSIL, and HPV type 16 may undergo conization immediately without colposcopic biopsy. Wesuggest that colposcopically directed 3 to 5 punch biopsies may be used to determine the need for conization.
