Prospective Evaluation of Correlation between Modified Reid’s Colposcopic Index (RCI) and Histopathology Result from Colposcopic Directed Biopsy

Abstract

Objective: To evaluate correlation between Modified Reid Colposcopic Index and histopathology from colposcopic directed biopsy. Materials and Methods: At least atypical squamous cell of undetermined significance (ASC-US) according to the Bethesda classification 2001 was diagnosed in 60 eligible women. At the time of colposcopic examination, the four colposcopic criteria used are: 1) margin of cervical lesion, 2) color of acetowhite, 3) appearance of vessels on cervical lesion, and 4) location of the lesion. Each criterion was assigned in score between 0 to 2 and the summation of all four criteria made a total score ranging from 0 to 8. A score of less than or equal to 2 was classified as low grade lesion indicating of human papillomavirus (HPV) infection or cervical intraepithelial neoplasia (CIN)1. Intermediate grade was 3 to 5 indicating of CIN2 while, high grade lesion as a reflection of at least CIN3 is 6 to 8. Colposcopic directed biopsy on all lesions were performed for histopathologic examination. Results: The strength of agreement with Spearman rank correlation was 0.69. Sensitivity, specificity, positive and negative predictive value for differentiate high from low grade lesion were 91.7%, 66.7%, 64.7% and 92.3%, respectively. The overall accuracy of modified RCI after adjusted was 76.7%. Accuracy in a subgroup of low and high grade lesion were 92.3% and 64.7%, respectively. Conclusion: Modified Reid’s colposcopic index had a good positive correlation to cervical histopathology and also had high accuracy to differentiate low from high grade lesion. Keywords: Modified Reid’s Colposcopic Index; Colposcopic directed biopsy; Colposcopy; Intraepithelial cervical neoplasia