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Evaluation of the accuracy of colposcopy in detecting high-grade squamous intraepithelial lesion and cervical cancer

  • Images in Obstetrics and Gynecology
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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.

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Funding

We thank the support of Special Fund Project of “Fundamental Research Funds for the Central Universities” of Tongji University (22120190241 and 22120190214), the National Natural Science Foundation of China (81771529), and the Shanghai Science and Technology Development Foundation (17441902500).

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, East Hospital, Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200120, China

    Yetian Ruan, Min Liu, Junhan Guo, Junwei Zhao, Sumei Niu & Fang Li

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  1. Yetian Ruan
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  2. Min Liu
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  3. Junhan Guo
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  4. Junwei Zhao
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Correspondence to Fang Li.

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The authors declare that they have no conflict of interest.

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This study was approved by the Scientific and Ethical Committee of the Affiliated Hospital of Tongji University (permit number: KS1690).

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Informed consent was obtained from all individual participants included in the study.

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Ruan, Y., Liu, M., Guo, J. et al. Evaluation of the accuracy of colposcopy in detecting high-grade squamous intraepithelial lesion and cervical cancer. Arch Gynecol Obstet 302, 1529–1538 (2020). https://doi.org/10.1007/s00404-020-05740-x

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