Abstract
THE ACCURACY OF DIAGNOSING CERVICAL INTRAEPITHELIAL NEOPLASIA BY COLPOSCOPY AND ITS RELATED INFLUENCING FACTORS

Yehong Huang, Duanying Guo and Zhihua Liu*

ABSTRACT

Background: Colposcopy-directed biopsy is a basic method for diagnosing cervical intraepithelial neoplasia. This study aimed to evaluate the accuracy of colposcopy in the diagnosis of cervical intraepithelial neoplasia (CIN)and cervical cancer. Methods: A retrospective analysis was performed on 700 patients who underwent colposcopy examination and biopsy under direct vision in our hospital in January 2018 and November 2019. The pathological results of colposcopy diagnosis and biopsy were compared, and the influence of high-risk HPV results and cervical cytology results on the accuracy of colposcopy diagnosis of cervical diseases was. Results: From a total number of 700 patients, there were 100 patients (14.3%) had pathological diagnosis of low-grade cervical intraepithelial neoplasia, and 96 (13.7%) had pathological diagnosis of high-grade cervical intraepithelial neoplasia or cervical cancer, 429 (61.3%) cases diagnosed by colposcope met the accuracy diagnosis by pathological biopsy. The overdiagnosis rate by colposcopy was noticed in 25.7% (180/700) cases, and the lack of diagnosis rate was observed in 13.0% (91/700) cases. high-risk HPV-negative patients who underwent colposcopy diagnosis accuracy rate (68.2%), the high-risk HPV-positive patients was (60.3%), however the difference was not significant. Conclusion: The specificity and positive predictive value of colposcopy in the diagnosis of high-grade lesions are high, and biopsy guided by colposcopy should be performed to avoid missed diagnosis of high-grade intraepithelial neoplasia and cervical cancer. When HPV was positive in high risk, the specificity of normal colposcopic diagnosis and positive predictive value were high, and if cytology was low change, especially at ASCUS, biopsy could be considered to be avoided. When high risk HPV is positive, the accuracy of colposcopy in diagnosing normal or low-grade lesions is associated with cytological results to some extent, but cytological results are not enough to bypass biopsy.

Keywords: Cervical intraepithelial neoplasia; Cervical cancer, Colposcopy; HPV.


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