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

• Published in: Revista Brasileira de ginecologia e obstetrícia Vol. 40; no. 7; pp. 410 - 416
• Main Authors: Fachetti-Machado, Giselle, Figueiredo-Alves, Rosane Ribeiro, Moreira, Marise Amaral Rebouças
• Format: Journal Article
• Language: English
• Published: Brazil Federação Brasileira das Sociedades de Ginecologia e Obstetrícia 01-07-2018
• Subjects: adenocarcinoma in situ; Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Carcinoma, Squamous Cell - pathology; cervical intraepithelial neoplasia; Cervix Uteri - pathology; Colposcopy; Cross-Sectional Studies; Female; Humans; Middle Aged; Neoplasms, Glandular and Epithelial - pathology; OBSTETRICS & GYNECOLOGY; papanicolaou test; Predictive Value of Tests; Retrospective Studies; sensitivity and specificity; squamous intraepithelial lesions of the cervix; uterine cervical neoplasms; Young Adult; adenocarcinoma in situ; sensibilidade e especificidade; exame colpocitológico; squamous intraepithelial lesions of the cervix; neoplasias do colo do útero; colposcopia; cervical intraepithelial neoplasia; sensitivity and specificity; neoplasia intraepitelial cervical; colposcopy; uterine cervical neoplasms; lesões intraepiteliais escamosas cervicais; papanicolaou test
• ISSN: 0100-7203; 1806-9339; 1806-9339
• DOI: 10.1055/s-0038-1666995

To estimate the cytological and colposcopic performances for the diagnosis of cervical neoplasias.
 Cross-sectional retrospective study with data from patients' charts. The participants underwent colposcopy, guided biopsies, and excision when needed. The cytological and colposcopic categorization followed the Bethesda System and the international colposcopic terminologies. The cytology and colposcopy performances were evaluated by sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) analyses with 95% confidence interval (95% CI).
 From 1,571 participants, a total of 1,154 (73.4%) were diagnosed with cervical squamous intraepithelial neoplasia grade 2 or worse (CIN 2
), 114 (7.2%) with adenocarcinoma in situ or worse (AIS
), 615 (39.2%) presented atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion or worse (ASC-H
) cytology, and 934 (59.4%) presented major or suspicious for invasion colposcopic abnormalities. The SE, SP, PPV, and NPV of ASC-H
for diagnoses of CIN 2
and AIS
were, respectively: 44% (95% CI: 41-47) and 72% (95% CI: 67-76), 79% (95% CI: 77-81) and 79% (95% CI: 75-83), 88% (95% CI: 87-90) and 55% (95% CI: 50-60), and 28% (95% CI: 26-31) and 88% (95% CI: 85-91). The SE, SP, PPV, and NPV of major or suspicious for invasion colposcopic abnormalities for diagnoses of CIN 2
and AIS
were, respectively: 62% (95% CI: 60-65) and 86% (95% CI: 83-89), 59% (95% CI: 57-62) and 59% (95% CI: 55-64), 85% (95% CI: 83-87) and 44% (95% CI: 40-49), and 29% (95% CI: 27-32) and 92% (95% CI: 89-94).
 The SE analyses results of ASC-H
and major or suspicious for invasion colposcopic abnormalities were higher for diagnoses of glandular neoplasias. These results confirm the role of cytology in identifying women at risk who will have their final diagnoses settled by colposcopy and histology.