| Objective:To evaluate the accuracy of colposcopy in the diagnosis of cervical intraepithelial neoplasia(CIN) and cervical cancer.Methods:A retrospective review of the colposcopic database, to identify all patients having their first colposcopy between September1,2014and October31,2014in our hopspital constituted the study population.700patient records were identified for analysis. Correlation of colposcopic impression and directed biopsies was performed. Analyze the high-risk type HPV results, cervical cytology on the accuracy of the colposcopy in the diagnosis of CIN and cervical cancer.Results:Colposcopy agreed exactly with histology in410cases (58.6%). Colposcopy agreed not exactly with histology in290cases (41.4%) including excessive diagnosis 17.7%(124/290) and the lack of diagnosis23.7%(166/290). Colposcopical accuracy of high-risk HPV negatie patients (82.4%) is significantly higher than the colposcopical accuracy of high-risk HPV positive patients (56.7%, p<0.01).In the26high-risk HPV negative and ASCUS cases, no case was CIN2+; in the19cases of high-risk HPV negative and LSIL,only1case was CIN2+. Colposcopical accuracy of high-risk HPV positive case is not high. Especially in352cases of normal colposcopical impression,33cases (9.4%) was CIN2+.Conclusion:Colposcopy has high specificity and sensitivity and positive predictive value. It should be biopsy under the guidance of colposcopy, in order to avoid misdiagnosis of cervical high-grade intraepithelial neoplasia and cervical cancer. When high-risk HPV is negative, the sensitivity and specificity of colposcopy for the threshold normal versus all cervical abnormalities were high. If cytology were low-grade lesions, especially ASCUS, it can consider to avoid biopsy. When high-risk HPV was positive, the accuracy of colposcopy for the threshold normal versus all cervical abnormalities was associated with cytology results, but the cytology results would not be enough to shunt biopsy. |
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