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Prediction of high-grade squamous intraepithelial lesions using the modified Reid index

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Abstract

Background

Colposcopic grading provides an objective and meaningful guide to histologic severity and neoplastic progression of squamous intraepithelial lesions of the cervix. The objective of this study was to develop a more efficient and convenient method to overcome procedural complexities involved with the traditional Reid index in prediction of high-grade squamous intraepithelial lesion (HSIL).

Methods

The Reid index uses four colposcopic signs (margin, color, vessel, and iodine staining). The proposed modified Reid index system specifically incorporates the location of the lesion within the transformation zone in place of iodine staining. Three hundred women with suspected or abnormal cytologies or abnormal cervicographic findings were evaluated by colposcopy, directed biopsy, and HPV testing by the Hybrid Capture II method, which detects high-risk HPV DNA types.

Results

The sensitivity of high-risk HPV testing for detecting HSIL was 94.4%, the specificity was 65.0%, the positive predictive value was 75.5%, and the negative predictive value was 91.0%. The results of the colposcopic impression using the modified Reid index were superior to HPV testing. The sensitivity, specificity, positive predictive value, and negative predictive value of the colposcopic impression for detecting HSIL were 91.3, 92.9, 93.6, and 90.3% respectively.

Conclusion

These results strongly indicate that the modified Reid index can accurately predict the histologic grade of squamous intraepithelial lesions of the cervix and can be applied easily and objectively in clinical practice without affecting the diagnostic accuracy of the traditional Reid index.

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References

  1. Reid R, Scalzi P (1985) Genital warts and cervical cancer. VII: An improved colposcopic index for differentiating benign papillomaviral infections from high grade cervical intraepithelial neoplasia. Am J Obstet Gynecol 153:611–618

    CAS  PubMed  Google Scholar 

  2. Meisels A, Fortin R, Roy M (1977) Condylomatous lesions of the cervix. II: Cytologic, colposcopic and histologic study. Acta Cytol 21:379–390

    CAS  PubMed  Google Scholar 

  3. Kirkup W, Evans SA, Brough AK (1982) Cervical intraepithelial neoplasia and “warty” atypia. A study of colposcopic, histologic and cytological characteristics. Br J Obstet Gynecol 89:571–577

    CAS  Google Scholar 

  4. Coppleson M (1987) Colposcopic features of papillomaviral infection and premalignancy in the female lower genital tract. Obstet Gynecol Clin North Am 14:471–494

    CAS  PubMed  Google Scholar 

  5. Stafl A, Mattingly RF (1973) Colposcopic diagnosis of cervical neoplasia. Obstet Gynecol 41:168–176

    CAS  PubMed  Google Scholar 

  6. Addis IB, Hatch KD, Berek JS (2005) Intraepithelial disease of the cervix, vagina, and vulva. In: Jonathean SB (ed) Berek and Novak’s gynecology, 14th edn. Lippincott Williams & Wilkins, Philadelphia, pp 561–590

    Google Scholar 

  7. Hatch KD (1989) Handbook of colposcopy: diagnosis and treatment of lower genital tract neoplasia and HPV infections. Little Brown, Boston

    Google Scholar 

  8. Reid R, Campion MJ (1989) HPV-associated lesions of the cervix: biology and colpiscopic features. Clin Obstet Gynecol 32:157–579

    Article  CAS  PubMed  Google Scholar 

  9. zur Hausen H (1977) Human papillomavirus and their possible role in squamous cell carcinoma. Curr Top Microbiol Immunol 78:1–30

    CAS  PubMed  Google Scholar 

  10. National Cancer Institute Workshop (1989) The 1988 Bethesda system for reporting cervical/vaginal cytologic diagnosis. JAMA 262:931–934

    Article  Google Scholar 

  11. Costa S, Sideri M, Bucchi L et al (1998) Cervicography and HPV DNA testing as triage criteria for patients with abnormal Pap smear. Gynecol Oncol 71:404–409

    Article  CAS  PubMed  Google Scholar 

  12. Clavel C, Masure M, Bory JP et al (2001) Human papillomavirus testing primary screening for the detection of high-grace lesions: a study of 7932 women. Br J Cancer 89:1616–1623

    Article  Google Scholar 

  13. Schneider A, Hoyer H, Lotz B et al (2000) Screening for high-grade cervical intra-epithelial neoplasia and cancer by testing for high-risk HPV, routine cytology or colposcopy. Int J Cancer (Pred Oncol) 89:529–534

    Article  CAS  Google Scholar 

  14. Herrington CS, Evans MF, Hallam NF et al (1995) Human papillomavirus status in the prediction of high-grade cervical intraepithelial neoplasia in patients with persistent low-grade cervical cytological abnormalities. Br J Cancer 71:206–209

    CAS  PubMed  Google Scholar 

  15. Schneider A, Zahm DM, Kirchmayr R et al (1996) Screening for cervical intraepithelial neoplasia grade 2/3: validity of cytologic study, cervicography and human papillomavirus detection. Am J Obstet Gynecol 174:1534–1541

    Article  CAS  PubMed  Google Scholar 

  16. Carozzi F, Ronco G, Confortini M et al (2000) Prediction of high-grade cervical intraepithelial neoplasia in cytologically normal women by human papillomavirus testing. Br J Cancer 83:1462–1467

    Article  CAS  PubMed  Google Scholar 

  17. Shlay JC, Dunn T, Byers T et al (2000) Prediction of cervical intraepithelial neoplasia grade 2–3 using risk assessment and HPV testing in women with atypia on Papanicolaou smears. Obstet Gynecol 96:410–416

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest statement

The authors have no commercial, proprietary, or financial interests in the products or companies described in this article.

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Correspondence to Young L. Cho.

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Hong, D.G., Seong, W.J., Kim, S.Y. et al. Prediction of high-grade squamous intraepithelial lesions using the modified Reid index. Int J Clin Oncol 15, 65–69 (2010). https://doi.org/10.1007/s10147-009-0012-6

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  • DOI: https://doi.org/10.1007/s10147-009-0012-6

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