The accuracy of colposcopically directed biopsy in diagnosis of CIN

Helmerhorst, Th.J.M.; Dijkhuizen, G.H.; Calame, J.J.; Kwikkel, H.J.; Stolk, J.

doi:10.1016/0028-2243(87)90021-9

Cited by 13 publications

(10 citation statements)

References 21 publications

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“…One microinvasive carcinoma was missed, but the colposcopy was performed 6 weeks after delivery. The overall accuracy rate in our study was comparable to the 62 to 96% in the literature review published by Helmerhorst et al in 1987. In the present series the frequency of complete excision by conization was 94%. Compared with the figures given in the literature (60% to 94%) our results are excellent (Ahlgren et al 1975, Kolstad et al 1976, Burghardt et al 1980, Larsson 1983.…”

Section: Discussionsupporting

confidence: 92%

Conization for CIN associated with human papillomavirus infection

Yliskoski

Saarikoski

Syrjänen

1991

Arch Gynecol Obstet

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We report results of follow-up by PAP smears and colposcopy in 116 women treated since 1981 by conization for cervical intraepithelial neoplasia with human papillomavirus infection (HPV-CIN). The mean follow-up time was 31.9 (SD 19) months. Preoperative diagnosis was HPV-CIN II (with extension into the endocervix) in 11 cases and HPV-CIN III in 103 cases; two diagnostic conizations were performed. The histological examination of the cone biopsies showed complete excision of CIN in 109 cases (94%). Three patients underwent hysterectomy after conization; one had microinvasion in the cone biopsy, one had suspicion of microinvasion and one had non-radical conization. Three patients (2.6%) were lost to follow-up. After excluding these six patients the primary cure rate of HPV lesions (normal cytological and colposcopical finding after conization) was 82.7%. Four patients (4.6%) had residual CIN after conization. During the follow-up 15 patients had recurrence of HPV infection, only one had HPV-CIN I. HPV 16 was the most common HPV type (56/116, 48.2%) in the conization group and also in the recurrent cases (9/15, 60%). The results support the role of HPV 16 in cervical carcinogenesis.

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Section: Discussionsupporting

confidence: 92%

Conization for CIN associated with human papillomavirus infection

Yliskoski

Saarikoski

Syrjänen

1991

Arch Gynecol Obstet

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“…In our series there are significant association of cervical precancers and cancer cases with poor socioeconomic conditions, early age at marriage and high parity. These sociodemographic profile is comparable with other studies 13,14 During the last decade there has been an increasing interest in the use of colposcope 15 . Colposcopy guided biopsy is described as the reference investigation or "gold standard" for the diagnosis of cervical precancer 16 .…”

Section: Resultssupporting

confidence: 75%

Prevalence of High Risk Human Papillomavirus (type-16 and 18) in High-Grade Cervical Intraepithelial Neoplasia (CIN) and Cervical Cancer in a Tertiary Hospital of Bangladesh

Shahida

Ansary

Begum

et al. 2018

J. Bangladesh Coll. Phys.

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“…The reported sensitivities ranged from 55.9 to 100.0%. Studies that reported 100% sensitivity were retrospective in design 25,28,29 . Three out of four of the prospective studies with immediate excision biopsies were at the upper end of the specificity spectrum 67.5–79.4%, but showed lower sensitivity (55.9–82.8%) 8,35,53 .…”

Section: Resultsmentioning

confidence: 99%

“…Studies that reported 100% sensitivity were retrospective in design. 25,28,29 Three out of four of the prospective studies with immediate excision biopsies were at the upper end of the specificity spectrum 67.5-79.4%, but showed lower sensitivity (55.9-82.8%). 8,35,53 Four studies reported specificities of <5% but sensitivities between 87.4 and 99.2%.…”

Section: Accuracy Of Punch Biopsiesmentioning

confidence: 96%

Accuracy of colposcopy‐directed punch biopsies: a systematic review and meta‐analysis

Underwood

Arbyn

Smith

et al. 2012

BJOG

101

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Background The colposcopy-directed punch biopsy is widely used in the management of women with abnormal cervical cytology; however, its accuracy compared with definitive histology from an excision biopsy is not well established.Objectives To assess the accuracy of the colposcopy-directed punch biopsy to diagnose high-grade cervical intraepithelial neoplasia (CIN) by performing a systematic review and meta-analysis.Search strategy A systematic search of MEDLINE, EMBASE and the Cochrane Library was performed.Selection criteria Articles that compared the colposcopically directed cervical punch biopsy with definitive histology from an excisional cervical biopsy or hysterectomy.Data collection and analysis Random effects and hierarchical summary receiver operating characteristic regression models were used to compute the pooled sensitivity and specificity applying different test cut-offs for outcomes of high-grade CIN.Main results Thirty-two papers comprising 7873 paired punch/ definitive histology results were identified. The pooled sensitivity for a punch biopsy defined as test cut-off CIN1+ to diagnose CIN2+ disease was 91.3% (95% CI 85.3-94.9%) and the specificity was 24.6% (95% CI 16.0-35.9%). In most of the studies, the majority of enrolled women had positive punch biopsies. Pooling of the four studies where the excision biopsy was performed immediately after the punch biopsy, and where the rate of positive punch biopsies was considerably lower, yielded a sensitivity of 81.4% and specificity of 63.3%.Author's conclusion The observed high sensitivity of the punch biopsy derived from all studies is probably the result of verification bias.

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The accuracy of colposcopically directed biopsy in diagnosis of CIN

Cited by 13 publications

References 21 publications

Conization for CIN associated with human papillomavirus infection

Conization for CIN associated with human papillomavirus infection

Prevalence of High Risk Human Papillomavirus (type-16 and 18) in High-Grade Cervical Intraepithelial Neoplasia (CIN) and Cervical Cancer in a Tertiary Hospital of Bangladesh

Accuracy of colposcopy‐directed punch biopsies: a systematic review and meta‐analysis

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