Healing of cervical epithelium after laser ablation of cervical intraepithelial neoplasia

SUMMARY Healing of cervical epithelium was studied in 30 patients after destruction of cervical intraepithelial neoplasia using a carbon dioxide laser. Repeated examinations, using photography and colposcopically directed punch biopsies, were made from the eighth to the 32nd day after treatment. The biopsy specimens were submitted to examination by light and transmission elec-tron microscopy. There was complete epithelial cover of the laser induced craters in all patients by 28 days. The base of the crater and endocervical edge became covered by columnar epithelial cells originating in endocervical crypts, while the vaginal edge re-epithelialised by an ingrowth of the surrounding squamous epithelium. Squamous metaplasia of the new columnar epithelium was a common observation as early as eight days after treatment. There was no evidence for a stromal contribution to epithelial cover. The carbon dioxide laser was introduced to gynaecological practice to treat premalignant lesions of the uterine cervix. '-5 These lesions, termed cervi-cal intraepithelial neoplasia (CIN) by Richart,6 affect not only surface squamous epithelium of th