Correlations between Colposcopy Findings and Histopathological Results from Colposcopy Directed Biopsy in Cervical Pre-Cancerous Lesions

Abstract

Introduction: Cervical Intraepithelial Neoplasia is a precancerous condition in which abnormal cells grow on the surface of the cervix. CIN is a symptomless illness that often goes undetected by the naked eye. In most cases, the afflicted cervix appears to be in excellent health. As a result, the illness is detected by chance during cervicological histology or as a result of programs for routine cervical cytology or colposcopy screening. Colposcopy is an extra and valuable technique for identifying cervix anomalies. This study aimed to analyze the correlations between colposcopy findings and histopathological results from colposcopy-directed biopsy in cervical pre-cancerous lesions. Methods: A prospective observational study was conducted at the Department of Gynecology and Obstetrics, Chittagong Medical College Hospital, Chittagong, from September 2014 to February 2015. VIA-positive 72 women fulfilling all inclusion criteria who attended at colposcopy clinic of CMCH were included in the study. Statistical analyses were done by using the Statistical Package for Social Sciences (SPSS) version 16.0 for Windows. The quantitative observations were indicated by frequencies and percentages. Result: In the present study, the majority of the participants were over the age of 30 years, with 43.1% being in the age group of 30-39 years. Another 30.6% were from the age group of 40-49 years, while only 15.2% were from the age group of 20-29 years. Colposcopy findings were normal in 9.7% of the participants. CIN I was observed in the majority of the participants (54.2%), while CIN II and CIN III were observed in 29.2% and 6.94% respectively. According to the colposcopy-directed biopsy results, 5.6% of patients had normal outcomes, 7.7% had inflammations, 45.8% had CIN I, 30.6% had CIN II and 8.3% had CIN III. The correlation was calculated by reporting the number of cases histologically confirmed to the number of cases of colposcopic diagnosis for each lesion group separately. The correlation was 71.8% (28 out of 39) in the CIN I category, 76.2% (16 out of 21) in the CIN II category, and 75% (3 out of 4) in the CIN III category. The sensitivity and specificity of colposcopy were calculated considering a colposcopy-directed biopsy. Colposcopy findings revealed 65 CIN positive cases and 07 CIN negative cases, while biopsy findings revealed 60 positive and 12 negative cases. The sensitivity of colposcopy was 96.7%, specificity was 41.6%, the false positive rate was 58.4% and the false negative rate was 03.3% according to this study. Conclusion: This study demonstrated high accuracy and correlation between colposcopy and histology. The sensitivity of colposcopy was 96.7%, specificity was 41.6%, the false positive rate was 58.4% and the false negative rate was 03.3%. Specificity was lower in this study probably because biopsies were performed in all cases during diagnostic workups.