Performance of Conventional Cytology and Colposcopy for the Diagnosis of Cervical Squamous and Glandular Neoplasias

Fachetti-Machado, Giselle; Alves, Rosane Ribeiro Figueiredo; Moreira, Marise Amaral Rebouças

doi:10.1055/s-0038-1666995

Cited by 3 publications

(1 citation statement)

References 28 publications

(35 reference statements)

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“…However, the specificity of the former was higher [79.0% (95% CI: 77.0–81.0%) and 79.0% (95% CI: 75.0–83.0%), respectively] compared to the latter [59.0% (95% CI: 57.0–62.0%) and 59.0% (95% CI: 55.0–64.0%)], respectively. The low and lesser specificity of major or suspicious for invasion colposcopy findings reiterates that some sort of screening prior to colposcopy is essential to identify potentially positive patients to precursor neoplasias of cervical cancer [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Performance of three colposcopic images for the identification of squamous and glandular cervical precursor neoplasias

Fachetti-Machado

Alves

Moreira

2021

Arch Gynecol Obstet

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Purpose To evaluate prevalence and diagnostic performance of three colposcopic images to diagnose squamous and glandular cervical precursor neoplasias. Methods Cross-sectional study, conducted through analysis of stored digital colposcopic images. To evaluate the diagnostic performance of three images, herein named grouped glands, aceto-white villi, and atypical vessels, for detection of adenocarcinoma in situ (AIS) and cervical squamous intraepithelial neoplasias (CIN) grades 2 and 3, calculations of sensitivity, specificity, accuracy, positive likelihood ratio, receiver operating characteristic (ROC) curve, and area under the curve (AUC) were made, with their respective 95% confidence intervals. Results Grouped glands, aceto-white villi, and atypical vessels images had: prevalence of 21.3, 53.8, and 33.8% in patients with AIS, and 16.2, 19.5, and 9.3% in those with CIN 2 and 3; for the diagnosis of AIS, sensitivity of 21.3, 53.8, and 33.8%, specificity of 89.8, 95.2, and 94.9%, accuracy of 76.6, 87.2, and 83.1%, positive likelihood ratio of 2.1, 11.2, and 6.6, and AUC of 0.55, 0.74, and 0.64; for the diagnosis of CIN 2 and 3, sensitivity of 16.2, 19.5, and 9.3%, specificity of 89.8, 95.2, and 94.9%, accuracy of 39.4, 43.4, and 36.3%, positive likelihood ratio of 1.6, 4.1, and 1, 8, and AUC of 0.53, 0.57, and 0.52, respectively. Conclusion Prevalence and accuracy of the three images were higher for the diagnosis of glandular than squamous cervical precursor neoplasias. Sensitivity, specificity, positive likelihood, and AUC of aceto-white villi and atypical vessels images were higher for the diagnosis of glandular than squamous cervical precursor neoplasias.

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Section: Discussionmentioning

confidence: 99%

Performance of three colposcopic images for the identification of squamous and glandular cervical precursor neoplasias

Fachetti-Machado

Alves

Moreira

2021

Arch Gynecol Obstet

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Knowledge of cytology results affects the performance of colposcopy: a crossover study

Lalande,

Clarke,

Undurraga

et al. 2024

BMC Women's Health

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Objective To determine whether knowledge of cytology affects the colposcopist’s diagnostic accuracy in the identification of cervical intraepithelial neoplasia grade 2 and worse (≥ CIN2). Method In this cross-over study, healthcare professionals interpreted colposcopy images from 80 patient cases with known histological diagnoses. For each case, 2 images taken with a colposcope were provided (native and after acetic acid application). Inclusion criteria consisted of women with a transformation zone type 1 or 2, who had both a cytological and histological diagnosis. Cases were distributed across two online surveys, one including and one omitting the cytology. A wash-out period of six weeks between surveys was implemented. Colposcopists were asked to give their diagnosis for each case as < CIN2 or ≥ CIN2 on both assessments. Statistical analysis was conducted to compare the two interpretations. Results Knowledge of cytology significantly improved the sensitivity when interpreting colposcopic images, from 51.1% [95%CI: 39.3 to 62.8] to 63.7% [95%CI: 52.1 to 73.9] and improved the specificity from 63.5% [95%CI: 52.3 to 73.5] to 76.6% [95%CI: 67.2 to 84.0]. Sensitivity was higher by 38.6% when a high-grade cytology (ASC-H, HSIL, AGC) was communicated compared to a low-grade cytology (inflammation, ASC-US, LSIL). Specificity was higher by 31% when a low-grade cytology was communicated compared to a high-grade. Conclusions Our data suggests that knowledge of cytology increases sensitivity and specificity for diagnosis of ≥ CIN2 lesions at colposcopy. Association between cytology and histology may have contributed to the findings.

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Knowledge of cytology results affects the performance of colposcopy: a crossover study

Lalande,

Clarke,

Undurraga

et al. 2023

Preprint

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Objective – To determine whether knowledge of cytology affects the colposcopist’s diagnostic accuracy in the identification of cervical intraepithelial neoplasia grade 2 and worse (≥ CIN2). Method – In this cross-over study, healthcare professionals interpreted colposcopy images from 80 patient cases with known histological diagnoses. For each case, 2 images taken with a colposcope were provided (native and after acetic acid application). Inclusion criteria consisted of women with a transformation zone type 1 or 2, who had both a cytological and histological diagnosis. Cases were distributed across two online surveys, one including and one omitting the cytology. A wash-out period of six weeks between surveys was implemented. Colposcopists were asked to give their diagnosis for each case as < CIN2 or ≥ CIN2 on both assessments. Statistical analysis was conducted to compare the two interpretations. Results – Knowledge of cytology significantly improved the sensitivity when interpreting colposcopic images, from 51.1% [95%CI: 39.3 to 62.8] to 63.7% [95%CI: 52.1 to 73.9] and improved the specificity from 63.5% [95%CI: 52.3 to 73.5] to 76.6% [95%CI: 67.2 to 84.0]. Sensitivity was higher by 38.6% when a high-grade cytology (ASC-H, HSIL, AGC) was communicated compared to a low-grade cytology (inflammation, ASC-US, LSIL). Specificity was higher by 31% when a low-grade cytology was communicated compared to a high-grade. Conclusion – Our data suggests that knowledge of cytology increases sensitivity and specificity for diagnosis of ≥ CIN2 lesions at colposcopy. Association between cytology and histology may have contributed to the findings.

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Performance of Conventional Cytology and Colposcopy for the Diagnosis of Cervical Squamous and Glandular Neoplasias

Cited by 3 publications

References 28 publications

Performance of three colposcopic images for the identification of squamous and glandular cervical precursor neoplasias

Performance of three colposcopic images for the identification of squamous and glandular cervical precursor neoplasias

Knowledge of cytology results affects the performance of colposcopy: a crossover study

Knowledge of cytology results affects the performance of colposcopy: a crossover study

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