L Stewart Massad1, Yvonne C Collins. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Southern Illinois University, Springfield, IL 62794, USA. LSMASSAD@ameritech.net
Abstract
OBJECTIVE: The aim of this study was to determine the strength of the correlation between colposcopic impression and biopsy histology. METHODS: In an urban referral clinic, colposcopy and directed biopsy were performed between July 1, 1996, and December 31, 1999, by residents supervised by board-certified attending obstetrician-gynecologists. Impression and biopsy were graded as benign, suggesting condyloma or koilocytosis, cervical intraepithelial neoplasia (CIN) grades 1-3, or cancer. The significance of association was assessed by chi(2) testing and the strength by kappa statistics. RESULTS: Colposcopies were performed on 2825 women, with colposcopic impression and biopsy grade known for 2112. Exact agreement was found in only 893 (37%) women, but results agreed within one grade in 1203 (75%). The association between impression and histology was significant (P < 0.001), but the strength of the correlation was poor (0.20). The positive predictive value of any colposcopic abnormality for any histologic abnormality was 80%. The negative predictive value of a benign colposcopic impression was 68%. The sensitivity of colposcopy with a threshold of any lesion detected was 89%, and the specificity was 52%. The sensitivity for CIN 2/3 was 56%. CONCLUSION: Colposcopy is imprecise, although useful in estimating lesion grade. Management decisions require biopsy.
OBJECTIVE: The aim of this study was to determine the strength of the correlation between colposcopic impression and biopsy histology. METHODS: In an urban referral clinic, colposcopy and directed biopsy were performed between July 1, 1996, and December 31, 1999, by residents supervised by board-certified attending obstetrician-gynecologists. Impression and biopsy were graded as benign, suggesting condyloma or koilocytosis, cervical intraepithelial neoplasia (CIN) grades 1-3, or cancer. The significance of association was assessed by chi(2) testing and the strength by kappa statistics. RESULTS: Colposcopies were performed on 2825 women, with colposcopic impression and biopsy grade known for 2112. Exact agreement was found in only 893 (37%) women, but results agreed within one grade in 1203 (75%). The association between impression and histology was significant (P < 0.001), but the strength of the correlation was poor (0.20). The positive predictive value of any colposcopic abnormality for any histologic abnormality was 80%. The negative predictive value of a benign colposcopic impression was 68%. The sensitivity of colposcopy with a threshold of any lesion detected was 89%, and the specificity was 52%. The sensitivity for CIN 2/3 was 56%. CONCLUSION: Colposcopy is imprecise, although useful in estimating lesion grade. Management decisions require biopsy.
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Authors: Judith R Mourant; Thérese J Bocklage; Tamara M Powers; Heather M Greene; Maxine H Dorin; Alan G Waxman; Meggan M Zsemlye; Harriet O Smith Journal: J Low Genit Tract Dis Date: 2009-10 Impact factor: 1.925
Authors: Frederique J Vink; Stèfanie Dick; Daniëlle A M Heideman; Lise M A De Strooper; Renske D M Steenbergen; Birgit I Lissenberg-Witte; Arno Floore; Jesper H Bonde; Anja Oštrbenk Valenčak; Mario Poljak; Karl U Petry; Peter Hillemanns; Nienke E van Trommel; Johannes Berkhof; Maaike C G Bleeker; Chris J L M Meijer Journal: Int J Cancer Date: 2021-05-11 Impact factor: 7.396