Performance of colposcopic scoring by modified International Federation of Cervical Pathology and Colposcopy terminology for diagnosing cervical intraepithelial neoplasia in a low-resource setting

Rema, P.; Mathew, Arun Peter; Thomas, Shaji

doi:10.4103/sajc.sajc_302_18

Cited by 12 publications

(16 citation statements)

References 15 publications

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“…9,13,14,16 Therefore, as the IFCPC nomenclature for the vagina becomes better understood and applied-providing standardized interpretations of and an organized, comprehensive classification system for colposcopic findings of vaginal lesions-the accuracy of the colposcopic diagnosis on VaIN is being improved and approaching that for the cervix. [19][20][21][22] However, it should be noted that, in our study, the agreement rate was the lowest (35.71%) in the HSIL group, which was significantly different from that of the other lesion grade groups (LSIL and carcinoma). Although the accuracy of colposcopy for detecting VaIN was improved due to the implementation of the IFCPC nomenclature, more definite and practical findings for highgrade VaIN colposcopic patterns may be needed in further studies.…”

Section: Discussioncontrasting

confidence: 85%

<p>Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology on the Detection of Vaginal Intraepithelial Neoplasia</p>

Zhou¹,

Zhang²,

Sui³

et al. 2020

CMAR

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To evaluate the colposcopic accuracy of the detection of vaginal intraepithelial neoplasia (VaIN) according to the colposcopic terminology for the vagina from the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC). Methods: A total of 467 women who were suspected of having VaIN and underwent colposcopy at Obstetrics and Gynecology Hospital of Fudan University from January to December 2018 were included in this retrospective cohort study. The 2011 IFCPC revised terminology for the vagina was applied, and the agreement between colposcopic diagnosis and vaginal biopsy pathology was analysed. Results: Agreement between colposcopy and pathology was 69.16% (kappa=0.437, p<0.001), with 23.34% overestimated and 7.49% underestimated diagnosis for colposcopy. The agreement was the lowest (35.71%) in the high-grade VaIN group, which was significantly different from that of other lesion grade groups (p<0.01). Among grade 1 findings, thin acetowhite epithelium was the most frequent (80.51%). Grade 2 findings and vascular patterns were rare. The positive predictive values of the micropapillary pattern were 55.98% for low-grade VaIN and 5.98% for high-grade VaIN. The specificity of iodine negativity was 10.92% for low-grade VaIN and 8.30% for high-grade VaIN. There were significant differences in the maximum size of single lesions and in the number of lesions among different grade lesion groups. Conclusion: The agreement between colposcopy findings utilizing the 2011 IFCPC terminology and vaginal pathology is moderate, and more definite findings for high-grade VaIN may be needed. The micropapillary pattern can be considered an alternative low-grade finding, while iodine staining is nonspecific for all lesions. Scattered and spotty lesions suggest low-grade VaIN, while large single lesions suggest high-grade VaIN.

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Section: Discussioncontrasting

confidence: 85%

<p>Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology on the Detection of Vaginal Intraepithelial Neoplasia</p>

Zhou¹,

Zhang²,

Sui³

et al. 2020

CMAR

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“…The results showed the agreement between histopathology and colposcopy was 65.1% with weighted kappa = 0.597. It was equal to Li et al’s of 64.95% with consistency of kappa = 0.436, Fan et al’s of 65.5% with weighted kappa strength 0.494 and Prabhakaran’s of 65.7% [ 15 – 17 ]. Although IFCPC nomenclature was only moderate, it was better than Swede Score, RCI, modified RCI and 2002 IFCPC nomenclature [ 7 , 8 , 18 – 22 ].…”

Section: Discussionmentioning

confidence: 63%

Clinical application of the 2011 IFCPC colposcope terminology

et al. 2021

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Background Colposcopy offers an accurate way to the diagnose of cervical precancerous lesions. However, the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology. Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion The 2011 IFCPC colposcope terminology has standardized interpretations of the colposcopic findings and improved the accuracy of colposcopy diagnosis. The aceto-white epithelium still has important diagnostic value; however, the value of a few signs is needed to be discussed and new signs are expected to be discovered. Although the significance of Lugol’s staining was diminishing, mustard yellow might be a valuable indicator for the diagnosis of HSIL.

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“…The results showed the agreement between histopathology and colposcopy was 65.07% with weighted kappa = 0.5966. It was equal to Li et al's of 64.95% with consistency of kappa = 0.436, Fan et al's of 65.5% with weighted kappa strength 0.494 and Prabhakaran's of 65.7% [28][29][30]. Although IFCPC nomenclature was only moderate, it was better than Swede Score, RCI, modi ed RCI and IFCPC nomenclature [7,8,[31][32][33][34][35].…”

Section: General Assessment Of Colposcopic Ndingsmentioning

confidence: 72%

Clinical application of the 2011 IFCPC colposcope terminology in the era of HPV vaccines

Zhang

Hong

Zhang

et al. 2020

Preprint

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Background Colposcopy is the conjunction with screening and diagnosis of cervical precancerous lesions. However the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology.Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctuation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion With the wide acceptance of human papilloma virus (HPV) vaccines and HPV-based screening, there will be new challenges to accurately identify the signs of non-HPV16 and non-HPV18 infections and of minor lesions using colposcopy. In this study, we provide some recommendations in dealing with these challenges. More clinical research will be needed to further refine colposcopy terminology, improve diagnostic accuracy, and ensure that the World Health Organization’s goal of eliminating cervical cancer worldwide by 2030 is achieved.

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Performance of colposcopic scoring by modified International Federation of Cervical Pathology and Colposcopy terminology for diagnosing cervical intraepithelial neoplasia in a low-resource setting

Cited by 12 publications

References 15 publications

<p>Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology on the Detection of Vaginal Intraepithelial Neoplasia</p>

<p>Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology on the Detection of Vaginal Intraepithelial Neoplasia</p>

Clinical application of the 2011 IFCPC colposcope terminology

Clinical application of the 2011 IFCPC colposcope terminology in the era of HPV vaccines

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