Guidelines for Processing LEEP Specimens in the Histopathology Laboratory to Ensure High-Quality Diagnostic Slides

Abstract

Cervical cancer, primarily caused by Human Papillomavirus (HPV) infection, represents a significant public health challenge for women in Thailand. The Loop Electrosurgical Excision Procedure (LEEP) is a standard methodology for both diagnosing and treating early-stage lesions, and its success in guiding effective treatment and reducing the risk of recurrence is critically dependent on the accuracy of the pathological diagnosis. The quality of the histological slide prepared from a LEEP specimen is paramount to achieving this diagnostic precision. Therefore, every step within the pathology laboratory must be governed by stringent quality control protocols. This process begins with the gross examination, involving immediate specimen fixation, differential inking to delineate endocervical and ectocervical margins, and correct sectioning. The embedding stage requires specialized techniques to orient the characteristically thin LEEP tissues properly, which is essential for a complete evaluation of the lesion's surgical margins. This is followed by sectioning, which demands expertise in appropriately positioning the tissue block to obtain sections of just 3 microns in thickness. Finally, the slides are stained with Hematoxylin and Eosin (H&E) and undergo a final quality assessment. In conclusion, meticulous quality control throughout the entire laboratory workflow is fundamental to producing the highest quality diagnostic slides. This ensures an accurate diagnosis, which directly impacts the efficacy of clinical management and care for patients with cervical cancer.