Evaluation of the accuracy of colposcopy in detecting high-grade squamous intraepithelial lesion and cervical cancer
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IMAGES IN OBSTETRICS AND GYNECOLOGY
Evaluation of the accuracy of colposcopy in detecting high‑grade squamous intraepithelial lesion and cervical cancer Yetian Ruan1 · Min Liu1 · Junhan Guo1 · Junwei Zhao1 · Sumei Niu1 · Fang Li1 Received: 20 April 2020 / Accepted: 6 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The primary aim of this study was to evaluate the diagnostic accuracy of colposcopy in identifying high-grade squamous intraepithelial lesion or worse (HSIL+) and the characteristic performance of colposcopic images with various severity levels of cervical lesions. Methods The medical records from 1828 women who underwent colposcopy at Affiliated Hospital of Tongji University from February 2016 to March 2019 were reviewed. Human papilloma virus (HPV) GenoArray test kit (HybriBio Ltd) and Thinprep cytologic test (TCT, Hologic, USA) were used to perform HPV genotyping and cytology. All colposcopic images were collected from the standard-of-care colposcope (Leisegang 3ML LED) and evaluated based on the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) Colposcopy Standards. The linear by linear association, Pearson χ2 test, χ2 test, Kappa test, McNemar test and risk test were used to perform statistical analyses. Results The consistency between colposcopy and biopsy pathology was 59.35% with the moderate strength of kappa coefficient of 0.464. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of colposcopy and cytology for HSIL+ were 56.29%, 93.82%, 77.47%, 85.04% and 37.13%, 98.49%, 90.29%, 80.58%, respectively. The colposcopic features of HSIL+ were as follows: (1) thick or bulgy acetowhite epithelium with sharp border; (2) completely nonstained of Lugol’s iodine; (3) type III/IV/V of gland openings; (4) punctation or atypical vessels. Conclusion The data and findings herein provide the resource for evaluating the diagnostic value of colposcopy, and suggested that the accuracy of colposcopy is required to be further improved. Keywords Colposcopy · Accuracy · High-grade squamous intraepithelial lesion (HSIL) · Cervical cancer
Introduction Cervical cancer is the fourth most common cancers in women, with an estimated 569,847 new cases were diagnosed and 311,365 people died of this malignancy in 2018 worldwide [1]. As the second step of diagnosis and management for abnormal cervical cancer screening results, colposcopy is an indispensable tool for early detection of cervical precancerous lesions and cervical cancer. The Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00404-020-05740-x) contains supplementary material, which is available to authorized users. * Fang Li [email protected] 1
Department of Obstetrics and Gynecology, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai 200120, China
cervical biopsy directed by colposcopy is the gold standard for identifying cervical lesions [2]. Previous researches
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