Abstract
International Journal of Medicine and Public Health,2020,10,3,130-134.DOI:10.5530/ijmedph.2020.3.28Published:September 2020Type:Original ArticleRole of Colposcopy in Evaluation of Abnormal Cytology a Tertiary Care Centre ExperienceSachan Rekha, Shukla Ayushi, Sachan Pushpalata, Patel ML, and Shankhwar Pushpalata Sachan Rekha1,*, Shukla Ayushi1, Sachan Pushpalata2, Patel ML3, Shankhwar Pushpalata1 1Department of Obstetrics and Gynaecology, King George Medical University, Lucknow, Uttar Pradesh, INDIA. 2Department of Physiology, Career Institute of Medical Sciences, Lucknow, Uttar Pradesh, INDIA. 3Department of Medicine, King George Medical University, Lucknow, Uttar Pradesh, INDIA. Abstract:Background: Evidence for using colposcopy in the absence of a squamous intraepithelial lesion on conventional cytology has important position in cervical cancer screening. Aim of this study to evaluate sensitivity, specificity and diagnostic accuracy of colposcopy and cytology in unhealthy cervix to know role of colposcopy in concurrent use with cytology or replacing to cytology at tertiary centre experience. Methods: Prospective study was carried out over a period of one year, in patients attending Gynaecology OPD, King George’s Medical University, Lucknow, Uttar Pradesh. After informed consent and ethical clearance from institutional ethics committee, total 664 diagnostic colposcopy were performed in women presenting with gynaecological complaint. These women were called for concurrent colposcopy and pap smear. 41 women were lost to follow up, only 623 women were subjected for concurrent colposcopy and cytology. 99 women who had high grade colposcopy with Swede score ≥5 underwent colposcopic guided biopsy and tissue were sent for histopathological examination and cytology of same patients were compared for analysis. Results: Mean age of women was 42.68±11.69 years and mean age of consummation of marriage 20.94±3.21years. Cervical erosion was most common finding (41.4%) followed by hypertrophy of cervix (33.3%) and cervix bleeds on touch (17.2%). 24.14% (n=7) women with ASCUS cytology had high grade HPE (CIN2+) while 42.3% (n=11) women with LSIL had high grade HPE (CIN2+). Taking ASCUS and above as cut-off, the sensitivity, specificity, of Pap smear was 97.8%, 14.6% and diagnostic accuracy was 55.3%. For overall analysis of Colposcopy Swede Score at ≥5, colposcopy was 100% sensitive and 41.2% specific and diagnostic accuracy was 69.7%. At swede score ≥7, colposcopy was 64.6% sensitive and 100% specific and diagnostic accuracy was 82.8%. Conclusion: Colposcopy has good sensitivity and specificity as compared to cytology and can be used in evaluation of abnormal or controversial cytology to obtain better outcome. Keywords:Cervical cancer, Cervical intraepithelial neoplasia, Colposcopy, Cytology, Swede ScoreView:PDF (155.52 KB)
Highlights
Cervical cancer is a common cancer among women worldwide.[1]
These women were called for concurrent colposcopy and pap smear. 41 women were lost to follow up, only 623 women were subjected for concurrent colposcopy and cytology. 99 women who had high grade colposcopy with Swede score ≥5 underwent colposcopic guided biopsy and tissue were sent for histopathological examination and cytology of same patients were compared for analysis
Women who were not willing to participate, pregnant females, visible growth on cervix, acute PID, type 2 or 3 Transformation zone on colposcopy, immunocompromised subjects, or who have previously undergone any treatment for cervical intraepithelial neoplasia (CIN), or having any other malignancy were excluded from the study
Summary
Cervical cancer is a common cancer among women worldwide.[1]. In developing countries it is the second most common cancer and third highest reason for death due to cancer after breast and lung cancer. Et al.: Comparison between Colposcopy and Cytology in Unhealthy Cervix further evaluation by colposcopy and high grade colposcopy should be taken histopathology.[9,10,11]. It is well-established fact that 90 percent of mild dysplasia regress spontaneously or after treatment and only 10 percent of them either persist or progress to higher grade lesions. Further investigation of these high risk 10 percent cases will reduce the burden of follow up. This study was planned to evaluate sensitivity, specificity and diagnostic accuracy of colposcopy and cytology in unhealthy cervix and to evaluate the role of colposcopy in abnormal cytology at tertiary care centre experience
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