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Volume 7, Issue 4 (July - August 2022)                   J Obstet Gynecol Cancer Res 2022, 7(4): 279-285 | Back to browse issues page

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Allameh T, Kalatehjari M. The Values of Colposcopy in Patients with the Diagnosis of the High-Grade Squamous Intraepithelial Lesion in Routine Papanicolaou Test. J Obstet Gynecol Cancer Res. 2022; 7 (4) :279-285
URL: http://jogcr.com/article-1-470-en.html
1- Department of Obstetrics and gynecology, Isfahan University of Medical Sciences, Isfahan, Iran
2- Department of Obstetrics and gynecology, Isfahan University of Medical Sciences, Isfahan, Iran , mk.medicine@yahoo.com
Abstract:   (939 Views)

Background & Objective: Cervical cancer is one of the most preventable malignancies that can also be diagnosed in the early stages through screening tests. The Papanicolaou test (Pap smear) is the most conventional means for screening, while studies represent acceptable and more accurate outcomes of colposcopy in contrast to Pap smear. The current study aims to assess the values of colposcopy for cervical cancer diagnosis.
Materials & Methods: This is a cross-sectional study conducted on 94 patients diagnosed with high-grade squamous intraepithelial lesion (HSIL). After that, colposcopy was performed for all patients, and findings were presented as normal, chronic cervicitis, the thin acetowhite lesion (AWL), dense/thick AWL, AVP, pilling, and cauliflower-like mass. The biopsies were taken and pathological studies, as the gold standard was interpreted as normal, cervicitis, atypical squamous cells of undetermined significance (ASCUS), cervical intraepithelial neoplasia-1, -2 or -3 (CIN-1, -2 or -3), carcinoma-in-situ (CIS), adenocarcinoma and invasive squamous cell carcinoma (SCC).
Results: The pap-smear results were significantly associated with the biopsy reports (P<0.001; kappa=0.225). Besides, significant concordance was found between colposcopy and biopsy (P<0.001; kappa=0.247). The total sensitivity and specificity of colposcopy were based on the biopsy findings as the gold standard was 97% and 41%, respectively (P<0.001).
Conclusion: Colposcopy was significantly sensitive and specific for diagnosing both non-malignant CIN-1 and malignant cervical lesions, but not for CIN-2, -3, and CIS lesions. Further evaluations are strongly recommended.

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Systematic Review: Original Research | Subject: Obstetrics and Gynecology
Received: 2021/08/16 | Accepted: 2021/10/23 | Published: 2022/03/14

1. McGraw SL, Ferrante JM. Update on prevention and screening of cervical cancer. World J Clin Oncol. 2014;5(4):744-52. [DOI:10.5306/wjco.v5.i4.744] [PMID] [PMCID]
2. Bueno CT, Silva CMDd, Barcellos RB, Silva Jd, Santos CRd, Menezes JES, et al. Association between cervical lesion grade and micronucleus frequency in the Papanicolaou test. Genet Mol Biol. 2014;37(3):496-9. [DOI:10.1590/S1415-47572014000400004] [PMID] [PMCID]
3. Arbyn M, Castellsague X, de Sanjose S, Bruni L, Saraiya M, Bray F, et al. Worldwide burden of cervical cancer in 2008. Ann Oncol. 2011;22(12):2675-86. [DOI:10.1093/annonc/mdr015] [PMID]
4. Barut MU, Kale A, Kuyumcuoglu U, Bozkurt M, Agacayak E, Ozekinci S, et al. Analysis of Sensitivity, Specificity, and Positive and Negative Predictive Values of Smear and Colposcopy in Diagnosis of Premalignant and Malignant Cervical Lesions. Med Sci Monit. 2015;21:3860-7. [DOI:10.12659/MSM.895227] [PMID] [PMCID]
5. Koh WJ, Greer BE, Abu-Rustum NR, Apte SM, Campos SM, Cho KR, et al. Cervical Cancer, Version 2.2015. J Natl Compr Canc Netw. 2015;13(4):395-404; quiz [DOI:10.6004/jnccn.2015.0055] [PMID]
6. Pandey K, Bhagoliwal A, Jain S. Optical Imaging: Future Tool in Detection of Precancerous and Cancerous Lesions of Cervix and Its Comparison to Colposcopy. J Obstet Gynaecol India. 2015;65(3):176-80. [DOI:10.1007/s13224-014-0511-x] [PMID] [PMCID]
7. Giannella L. The clinical problem of colposcopy is represented by false-negatives. Arch Gynecol Obstet. 2015;291(4):711-2. [DOI:10.1007/s00404-015-3619-z] [PMID]
8. Sakano CR, Ribalta JC, Zucchi P. Tracking of cervical cancer in 7,519 patients: a study of the prevalence of altered cytologies. Eur J Gynaecol Oncol. 2015;36(4):437-41.
9. Mayeaux Jr EJ, Harper MB, Abreo F, Pope JB, Phillips GS. A comparison of the reliability of repeat cervical smears and colposcopy in patients with abnormal cervical cytology. J Family Pract. 1995;40(1):57-63.
10. Massad LS, Collins YC, Meyer PM. Biopsy correlates of abnormal cervical cytology classified using the Bethesda system. Gynecol Oncol. 2001;82(3):516-22. [DOI:10.1006/gyno.2001.6323] [PMID]
11. Karimi-Zarchi M, Peighmbari F, Karimi N, Rohi M, Chiti Z. A Comparison of 3 Ways of Conventional Pap Smear, Liquid-Based Cytology and Colposcopy vs Cervical Biopsy for Early Diagnosis of Premalignant Lesions or Cervical Cancer in Women with Abnormal Conventional Pap Test. Int J Biomed Sci. 2013;9(4):205-10.
12. Koutsky LA, Holmes KK, Critchlow CW, Stevens CE, Paavonen J, Beckmann AM, et al. A cohort study of the risk of cervical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirus infection. N Engl J Med. 1992;327(18):1272-8. [DOI:10.1056/NEJM199210293271804] [PMID]
13. McKee MD, Lurio J, Marantz P, Burton W, Mulvihill M. Barriers to follow-up of abnormal Papanicolaou smears in an urban community health center. Arch Fam Med. 1999;8(2):129-34. [DOI:10.1001/archfami.8.2.129] [PMID]
14. Lonky NM, Sadeghi M, Tsadik GW, Petitti D. The clinical significance of the poor correlation of cervical dysplasia and cervical malignancy with referral cytologic results. Am J Obstet Gynecol. 1999;181(3):560-6. [DOI:10.1016/S0002-9378(99)70493-X]
15. Cuzick J, Clavel C, Petry KU, Meijer CJ, Hoyer H, Ratnam S, et al. Overview of the European and North American studies on HPV testing in primary cervical cancer screening. Int J Cancer. 2006;119(5):1095-101. [DOI:10.1002/ijc.21955] [PMID]
16. Farzaneh F, Tamimi M, Amiri Z, Alizadeh K. The value of Pap smear in detecting cervical neoplasia compared with histopathologic findings in patients referred to Taleghani Hospital, Tehran 2007-2009. 2011.
17. Moy LM, Zhao FH, Li LY, Ma JF, Zhang QM, Chen F, et al. Human papillomavirus testing and cervical cytology in primary screening for cervical cancer among women in rural China: comparison of sensitivity, specificity, and frequency of referral. Int J Cancer. 2010;127(3):646-56. [DOI:10.1002/ijc.25071] [PMID]
18. Maiman M, Fruchter RG, Sedlis A, Feldman J, Chen P, Burk RD, et al. Prevalence, risk factors, and accuracy of cytologic screening for cervical intraepithelial neoplasia in women with the human immunodeficiency virus. Gynecol Oncol. 1998;68(3):233-9. [DOI:10.1006/gyno.1998.4938] [PMID]
19. McAdam M, Sakita J, Tarivonda L, Pang J, Frazer IH. Evaluation of a cervical cancer screening program based on HPV testing and LLETZ excision in a low resource setting. PloS one. 2010;5(10):e13266. [DOI:10.1371/journal.pone.0013266] [PMID] [PMCID]
20. Sayyah-Melli M, Rahmani V, Ouladsahebmadarek E, Jafari-Shobeiri M, Gharabaghi PM, Vahidi MN. Diagnostic Value of Pap Smear and Colposcopy in Non-benign Cervical Lesions. morbidity mortality. 2017;2:4. [DOI:10.15296/ijwhr.2019.35]
21. Zarchi MK, Binesh F, Kazemi Z, Teimoori S, Soltani HR. Value of Colposcopy in the Early Diagnosis of Cervical Cancer in Abnormal Pap Smears in Patients Referred to the Gynecology-Oncology Clinic at Shahid Sadoughi Hospital, Yazd. Asian Pac J Cancer Prevent. 2011;12:3439-41.
22. Ghaem Maghami F, Ensani F, Behtash N, Hosseini Nejad S. Histologic findings of uterine cervix among women with cytologic diagnosis of ASCUS (atypical squamous cells of undetermined significance). Tehran Univ Med J. 2004;62(4):326-31.
23. Matsuura Y, Kawagoe T, Toki N, Sugihara K, Kashimura M. Early cervical neoplasia confirmed by conization: diagnostic accuracy of cytology, colposcopy and punch biopsy. Acta Cytol. 1996;40(2):241-6. [DOI:10.1159/000333745] [PMID]

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