Identification of squamous intraepithelial lesions: fluorescence of cervical tissue during colposcopy.

Abstract

Objective. Our objective in this study was to improve the accuracy of colposcopically directed biopsy. Method. Women attending a colposcopy clinic because of an abnormal cytological cervical smear were entered into the study. A total of 154 cervical biopsy sites were investigated, using a fluorescence device developed to examine the differences in the spectral signatures of cervical tissue in different disease states. Acetowhite changes underwent biopsy, and a spectral signal was obtained. Each biopsy-optical pair was analyzed as an independent site, and the results were presented as independent comparisons of the paired data. Two groups of data are presented. Results. The optical readings indicated the presence or absence of any grade of cervical intraepithelial neoplasia with a specificity of 94.2% and 93.3%, respectively, and a sensitivity of 93.1% and 89.3%, respectively. The negative predictive values were 96.1% and 93.3%, respectively; the positive predictive values were 90% and 89.3%, respectively. Conclusion. The accuracy of the optical readings in this series was 93 to 94%. This methodology, with its excellent sensitivity, may serve a role in ensuring that all cervical intraepithelial neoplasia grades 2 and 3 lesions are identified and are subjected to biopsy during colposcopy.