Colposcopic Findings Research Articles

Analysis of the Impact of Pharmacological Intervention on the Outcome of High-Risk HPV Infections

This study aims to evaluate the clinical effectiveness of different drug treatment regimens for cervical high-risk human papillomavirus (HR-HPV) infection. Through literature review and randomized group experiment design, the study compares the HPV-DNA clearance rate, TCT results, and colposcopic biopsy findings among the control group, interferon group, and combination treatment group after six months of treatment. The results indicate that recombinant human interferon-2b vaginal effervescent tablets can effectively improve HPV clearance and reduce the risk of lesion progression, although individual responses to treatment vary. Combination therapy may enhance treatment efficacy by boosting immune response. The study also explores the relationship between drug treatment, viral load, cervical lesions, and vaginal microecology, providing scientific support for clinical medication decisions and offering a detailed analysis of the role of pharmacological intervention in the prognosis of HR-HPV infections.

A STUDY ON WOMEN ATTENDING GYNAECOLOGY OUTPATIENT DEPARTMENT UNDERGOING PAP SMEAR EXAMINATION AND FOLLOW-UP OF ABNORMAL PAP SMEAR USING COLPOSCOPY

Cervical cancer is the fourth most common cancer in women. In 2018, an estimated 570,000 women were diagnosed with cervical cancer worldwide and about 311,000 women died from the disease. It is the most common genital cancer among women in India. Pap smear is very useful in detecting abnormal cells and colposcopy locates the abnormal lesion when pap smear is abnormal. The objective of the study is to evaluate the women coming to the Gynaecology Outpatient Department undergoing pap smear and follow-up of abnormal smear using colposcopy. 103 women in the age group of 26-75(50.29+2.56) years who attended the gynecology outpatient department (GOPD)at a tertiary care teaching hospital in central Kerala with various clinical symptoms were screened by pap smear testing over two weeks. The smear was obtained using an Ayre spatula and it was spread over a glass slide which was placed in 95% ethyl alcohol in a coplin Jar. It was then sent to the department of pathology for cytopathological examination followed up using colposcopy and biopsy was done in the cases with abnormal colposcopy. Among these women,46.6 percentage have a normal pap smear 47.6% have an abnormal smear, and 5. 8 % have an atrophic smear. Among abnormal smear 4.8% are ASCUS, 1.9% LSIL, 0.97% SCC, 0.97% high-grade adenocarcinoma, and 37.86% inflammatory smears. As per International guidelines, women with abnormal pap smear tests should undergo colposcopy and those with abnormal colposcopy findings should undergo biopsy. Awareness about cancer should be increased and women should be motivated to undergo screening.

Evaluation of endocervical curettage (ECC) in colposcopy for detecting cervical intraepithelial lesions.

Diagnostic challenges in colposcopy arise especially in women aged 50 or older, with postmenopausal status and transformation zone type 3 (TZ3). Endocervical curettage (ECC) is a valuable tool for diagnosing intracervical lesions. The aim of this retrospective analysis was to evaluate the use of ECC in colposcopy for detecting cervical intraepithelial lesions. A retrospective study was carried out of colposcopies performed in the certified Dysplasia Unit at Erlangen University Hospital between July 2016 and June 2023. Pap and human papillomavirus (HPV) results were correlated with the histologic findings via ECC, obtained during examinations or surgery. The primary outcome was the rate of accuracy between the colposcopic and histologic findings with regard to cytology, age of patients, and type of transformation zone (TZ). A total of 429 colposcopies in 413 women with histologic samples obtained via ECC were included in the final analysis. In all, 355 women had TZ3. Among patients with TZ3, evidence of high-grade lesions and invasive carcinoma was also found in women with normal or low-grade abnormal cytology. For patients with normal colposcopic findings, cervical intraepithelial neoplasia (CIN) 2 and CIN3/adenocarcinoma in situ (AIS) were found in 56 patients (16%), and invasive carcinoma was found in four patients (0.1%). This analysis suggests that ECC is a valuable tool in the diagnosis of cervical intraepithelial neoplasia, especially for patients who present with a normal colposcopy of the cervix and vagina but have either recurrent abnormal cytologic findings or high-grade abnormal cytology indicating CIN2 + .

Early Cervical Cancer Diagnosis with SWIN-Transformer and Convolutional Neural Networks.

Introduction: Early diagnosis of cervical cancer at the precancerous stage is critical for effective treatment and improved patient outcomes. Objective: This study aims to explore the use of SWIN Transformer and Convolutional Neural Network (CNN) hybrid models combined with transfer learning to classify precancerous colposcopy images. Methods: Out of 913 images from 200 cases obtained from the Colposcopy Image Bank of the International Agency for Research on Cancer, 898 met quality standards and were classified as normal, precancerous, or cancerous based on colposcopy and histopathological findings. The cases corresponding to the 360 precancerous images, along with an equal number of normal cases, were divided into a 70/30 train-test split. The SWIN Transformer and CNN hybrid model combines the advantages of local feature extraction by CNNs with the global context modeling by SWIN Transformers, resulting in superior classification performance and a more automated process. The hybrid model approach involves enhancing image quality through preprocessing, extracting local features with CNNs, capturing the global context with the SWIN Transformer, integrating these features for classification, and refining the training process by tuning hyperparameters. Results: The trained model achieved the following classification performances on fivefold cross-validation data: a 94% Area Under the Curve (AUC), an 88% F1 score, and 87% accuracy. On two completely independent test sets, which were never seen by the model during training, the model achieved an 80% AUC, a 75% F1 score, and 75% accuracy on the first test set (precancerous vs. normal) and an 82% AUC, a 78% F1 score, and 75% accuracy on the second test set (cancer vs. normal). Conclusions: These high-performance metrics demonstrate the models' effectiveness in distinguishing precancerous from normal colposcopy images, even with modest datasets, limited data augmentation, and the smaller effect size of precancerous images compared to malignant lesions. The findings suggest that these techniques can significantly aid in the early detection of cervical cancer at the precancerous stage.

Comparative study of triage strategies for women with atypical squamous cells of undetermined significance in the post-vaccine era.

The research focused on a comparative analysis of triage strategies for women with Atypical Squamous Cells of Undetermined Significance (ASC-US) before and after receiving the HPV vaccine, aiming to optimize cervical cancer prevention strategies, especially in resource-limited healthcare settings. Between September 2018 and December 2023, 7,511 women aged 21 years or older who underwent liquid-based cytology for cervical cancer screening were recruited. Women diagnosed with ASC-US were included in the study. All participants underwent HPV testing and liquid-based cytology examination, and those with abnormal results were referred for colposcopy. Women with abnormal colposcopy findings underwent further histopathological examination. The gold standard for diagnosis was pathological, with cervical intraepithelial neoplasia grade 2 or higher (CIN2+) on histology as the endpoints. In the final analysis, 933 women with ASC-US were enrolled as the unvaccinated group, with 179 of them testing positive for HPV 16/18. Assuming that all women would receive the bivalent vaccine targeting HPV 16/18 in the post-vaccine era, and given that the vaccine protection rate is 100% against HPV 16/18, then 754 women excluding those of HPV 16/18 positive would comprise the vaccinated group. In the unvaccinated group, the overall HPV positivity rate was 59.27% among ASC-US women, with a 100% HPV prevalence rate among those with CIN2+ lesions. The combination genotyping model of HPV16/18 showed the highest specificity (81.77%) and the lowest referral rate (32.37%). In the vaccinated group, the HPV positivity rate was 49.61% among ASC-US women, with a 100% HPV prevalence rate among those with CIN2+ lesions. The specificity of HPV33/58 was the highest (86.99%), and the colposcopy referral rate was lowest (27.54%), with statistical significance. Sensitivity, positive predictive value, and negative predictive value were not statistically significant. HPV16/18 demonstrated a more efficacious triaging effect in the unvaccinated group. HPV33/58 will potentially replace HPV16/18 as the priority screening genotyping among vaccinated populations.

Cervical Cytological and Colposcopic Findings in Cases Associated with Prolonged Use of Intrauterine Devices versus Long Acting Injectable Contraceptive Agents

Cervical Cytological and Colposcopic Findings in Cases Associated with Prolonged Use of Intrauterine Devices versus Long Acting Injectable Contraceptive Agents

Clinical application of photoacoustic imaging for cervical precursor lesion detection.

Early diagnosis of a precursor lesion in the uterine cervix is an essential factor in uterine cervical cancer prevention. Although colposcopy is an established procedure for detecting high-risk patients, its accuracy and reproducibility are relatively low. Some supportive or alternative techniques to improve the early diagnosis of a precursor lesion have been studied, and correct diagnosis with high reliability using a minimally invasive, cost-effective technique has been pursued. This study aimed to examine the possibility of using photoacoustic (PA) imaging as a supportive technique to improve the accuracy of early diagnosis of cervical precursor lesions. A PA imaging system for microvessels was used to detect angiogenesis in severe lesions. A total of 21 patients who underwent surgical treatment and 114 outpatients who visited our colposcopy clinic were examined. A retrospective evaluation of PA images was performed as follows: (i) pathological assessment of the specific PA findings and (ii) retrospective evaluation of the severe lesion detection rate through PA. PA image evaluation and pathological findings showed dense angiogenesis in a severe precursor lesion appearing as a "hot spot" in the PA image. A comparison with colposcopy findings was performed for accuracy evaluation, and the detection rate of severe lesions using PA was relatively high (positive predictive value, 84.5%; negative predictive value, 82.1%). Our results indicate the possibility of using PA imaging for early diagnosis of severe cervical precursor lesions. With its ability to yield quantitative information, PA imaging can improve ultrasound diagnosis.

Correlation of Colposcopic Findings with Histologic Diagnosis in Cervical Lesions at Federal Medical Centre, Abuja

Correlation of Colposcopic Findings with Histologic Diagnosis in Cervical Lesions at Federal Medical Centre, Abuja

Is the colposcopic lesion size a predictor of high-grade lesions in young patients?

This study aimed to evaluate whether severity changes with colposcopic lesion size, regardless of age. This retrospective comparative study reviewed the records of 428 women with altered cytopathology reports who were directed by primary health care. Only those women with colposcopic alterations were evaluated (n=411). Histopathological analyses were restricted to patients who underwent excisional treatment (n=345). According to their age, they were grouped into the following: <21, 21-24, 25-35, and >35 years, and also, ≤24 and ≥25 years. The cytopathological, colposcopic, and histopathological findings were grouped according to severity. Lesion size was subjectively assessed from the colposcopic drawing recorded in the chart and according to the number of quadrants of the total cervical surface affected by colposcopic alterations in the transformation zone. Statistical significance was set at p<0.05. The evaluations suggested that the lesion size was directly related to the severity of the cytopathology, colposcopy, and histopathology reports for the age groups ≤24 or ≥25 years. We observed associations between lesion size and severity of the cytopathology (≤24 years, p=0.037) and histopathology (≥25 years, p=0.003) findings. The size of the lesion was directly related to the severity of the histopathological lesion in patients aged ≥25 years and cytopathological in patients aged ≤24 years.

Colposcopic Detection of CIN in Patients with Clinically Abnormal Cervix at a Tertiary Care Center in Bangladesh

Background: Cervical cancer poses a significant public health challenge globally, especially in regions like Bangladesh where access to effective screening programs is limited. Early detection and management of cervical intraepithelial neoplasia (CIN) play crucial roles in preventing the progression to cervical cancer. This study investigates the diagnostic accuracy of colposcopy, compared with histopathological findings, in detecting various grades of CIN and cervical cancer. Methods: This retrospective observational study reviewed hospital records of 200 VIA-positive cases from January 2021 to December 2023 at the Obstetrics and Gynecology Department of Holy Family Red Crescent Medical College Hospital Dhaka, Bangladesh. Colposcopic examinations were conducted, followed by histopathological evaluations of biopsied tissues to confirm the presence and grade of CIN. Data on demographic characteristics, clinical findings, and outcomes were analyzed using descriptive statistics. Result: Of the participants, 44% had normal colposcopic findings, while the prevalence of CIN I, CIN II, CIN III, and cervical cancer was 22.5%, 17%, 11%, and 4%, respectively. Histopathological correlation confirmed 46% as normal, with discrepancies noted in higher-grade lesion diagnosis. The study highlighted the high sensitivity but variable specificity of colposcopy in detecting and grading cervical lesions. Conclusion: Colposcopy serves as a valuable diagnostic tool in the early detection of cervical abnormalities. However, discrepancies in lesion grading underscore the need for integrating colposcopy with histopathological evaluations to enhance diagnostic accuracy and optimize patient management.

Colposcopic and Histopathologic Comparative Interpretations Among Patients Undergoing Evaluation for Cervical Dysplasia in Western Kenya

Objective: To determine the correlation between colposcopic and final histopathologic results amongst patients undergoing a colposcopic evaluation in cervical dysplasia clinics in Western Kenya. Methods: This was a cross-sectional study, conducted among 164 females undergoing colposcopic evaluation across several cervical dysplasia clinics in Western Kenya. Colposcopy and histopathology were performed. Colposcopy findings were graded using modified Reid’s Colposcopic Index (RCI). Bayes’ theorem model was used to determine the sensitivity, specificity, positive predictive value, and negative predictive value. An overall ĸ value was calculated as an estimate of the strength of correlation between colposcopy and histopathology. Results: Mean age of the study participants was 40.6 years. Modified RCI classified 20.7%, 40.2%, and 39.1% between a score of 0–2, 3–5, and 6–8, respectively. Colposcopy classified 0.6%, 38.4%, and 60.1% as normal, cervical intraepithelial neoplasia (CIN) 1 (low risk), and CIN 2–3 (medium–high risk), respectively. Histopathology classified 16.5%, 26.2%, 53.3%, and 3.0% as having normal, CIN 1, CIN 2–3, or carcinoma in situ, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 85.3%, 69.7%, 80.3%, and 69.7%, respectively. The estimated strength of correlation between colposcopy and biopsy was relatively strong (ĸ=0.55). Conclusion: There is an association between the discriminatory powers of colposcopy and histology, but colposcopy had a lower specificity when compared to histopathology.

Role of Geminin as a Tool for Augmenting Accurate Diagnosis of Cervical Neoplasia.

To determine the role of geminin as a tool for differentiating various types of cervical intraepithelial neoplasia (CIN) and cervical carcinoma (CC). Seventy women newly diagnosed with CIN or CC undergoing cervical biopsy were included; their clinical profile, human papilloma virus (HPV) positivity, and colposcopy findings were noted, and biopsy tissue was analyzed for geminin content. On geminin immunohistochemistry, 100% of women with CIN3 and 96.29% of women with CC had geminin two plus or more. When analyzed as ordinal variables, there was a significant correlation (spearman's rho 0.35, p 0.01) between geminin and biopsy results (CIN1, CIN2, CIN3, and CC). Screening tests for cervical cancer, like conventional pap smears, liquid-based pap smears, and triaging with HPV, have limitations. It is important to be able to differentiate between high-grade lesions, invasive cancer, and low-grade lesions. The detection of geminin in these cells may aid in the confirmation of the diagnosis and ensure adequate treatment. Cervical intraepithelial lesions and carcinoma cervix demonstrated a correlation between increased geminin expression in CIN1 vs. CC and CIN2 vs. CC. Geminin may be a potential surrogate marker for higher-grade cervical lesions, and further research is needed to corroborate evidence in this direction.

Diagnostic Performance between Colposcopy Findings and Histopathology Reports

Background: Cervical cancer is the most frequent cancer in women worldwide. With appropriate screening, the condition can be prevented and treated. Colposcopy is a useful tool in the diagnosis and management of precancerous cervical lesions following primary screening. The gold standard for identifying precancerous lesions is histopathology. Objective: The aim of this study is to evaluate the diagnostic performance between colposcopy findings and histopathology reports Methods: The cross-sectional observational study was conducted in the Department of Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2022 to June 2023. A total of 62 subjects were included in the study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, the mean age was found to be 36.8±11.9 years, with a range from 20 to &gt;51 years maximum 44 (71.0%) of the patients were within the age group of 20 - 40 years. The majority 37 (59.7%) of patients completed SSC and most of the patients 56 (90.3%) were housewives. Most of the patients 59 (95.2%) were Muslims and about 32 (51.6%) came from middle-income families. About 25 (40.3%) patients were married between the ages of 15-17 years. About 25 (40.3%) were between 16-18 years during their first delivery and about 26 (41.9%) had 3-4 children and 21 (33.9%) had more than 4 children. Most of the patients 43(69.4%) had history of received OCP. Regarding colposcopic diagnosis, 12.9% (n=8) were normal, 69.4% (n=43) were CIN I, 9.7% (n=6) were CIN II and 8.1% (n=5) were CIN III and 30.6% (n=19) chronic cervicitis, 46.8% (n=29) CIN I, 6.5% (n=4) CIN II, 6.5% (n=4) CIN III, 4.8% (n=3) carcinoma in situ and 4.8% (n=3) were invasive squamous cell carcinoma by the histopathological diagnosis. Conclusion: Colposcopy had a rather high diagnostic accuracy for histopathologically verified precancerous cervical lesions. Even if the results of the screening tests are normal, patients who report with postcoital and postmenopausal bleeding should have colposcopies and biopsies. Colposcopy also has a high sensitivity, therefore it is simple to use the "see and treat" approach to lower dropout rates.

Correlation of VIA Positive Cases with Colposcopic and Histopathological Findings in Diagnosis of Precancerous Lesion of Cervix in A Tertiary Care Hospital

Background: Cervical cancer prevention strategies are evolving by integrating new screening modalities such as human papillomavirus (HPV) DNA testing and visual inspection with acetic acid (VIA). Colposcopy, as a diagnostic tool, plays a crucial role in the management of abnormal cytology smears, especially in developed countries. However, its utilization and efficacy in resource-limited settings like Bangladesh remain underexplored. Objective: This study aimed to assess the correlation between VIA positivity and colposcopic/histopathological findings in diagnosing precancerous cervical lesions among women in Bangladesh. Method: A cross-sectional study was conducted among 200 women aged 30-60 attending the Gynecology OPD of Dhaka Medical College and Hospital. VIA positivity was determined, and all positive cases underwent colposcopic evaluation. Histopathological examination was performed for tissue samples obtained during colposcopy. Result: Among the participants, 21% were VIA-positive. Colposcopic evaluation revealed inflammation (26.2%), CIN I (38.1%), CIN II (11.1%), CIN III (9.5%), and invasive carcinoma (9.5%). Histopathology findings included inflammation (28.6%), CIN I (40.5%), CIN II (7.1%), and invasive carcinoma (16.7%). True positive and false positive cases were identified, with percentages calculated accordingly. Conclusion: Detailed colposcopic evaluation with guided biopsy is crucial for detecting pre-invasive and early cervical cancer. Integrating colposcopy into screening programs in Bangladesh could significantly reduce morbidity and mortality among young women.

Colposcopic findings to study cervical changes in reproductive age group women using various contraceptives.

Colposcopy has a key role to play in see-and-treat programs for premalignant cervical lesions. The aim of the study/was to observe cervical changes with a colposcope using the Swede scoring system in fertile age group women using various contraceptives: conventional methods (barrier methods, coitus interruptus), oral contraceptives (OCPs), copper-T and bilateral tubectomy. The aim of the study was to observe and evaluate the colposcopic findings using the Swede scoring system for the diagnosis of premalignant/malignant lesions in reproductive age group women using various contraceptives. This was a prospective observational study, conducted among 200 women of reproductive age group using various contraceptives in a tertiary care institute in North India. PAP smear, direct visual examination, VIA (Visual Inspection with Acetic Acid) examination, colposcopic examination, and (biopsy if indicated) were done. The data were collected, and analysis was done using Microsoft Excel Office Software 2019 version 19.11 and epi info (CDC Atlanta) 7.23.1. Statistical analysis was done using percentages, mean, mode, median, standard deviation, Chi-square, Fisher's Test, and Anova Test. We found positive PAP (Papanicolaou test) smears in 61.50%, positive VIA examination in 9%, and positive findings in colposcopic examination in 28.50%, Swede score of 0-3 in 100% (0-91%, 1-2%, 2-6%, and 3-1%) and positive biopsy in 9% subjects. Malignant findings were observed in 1.00% of PAP smears. Colposcopic findings were CIN 1 (cervical intraepithelial neoplasia 1) in 8.5% and CIN 2 in 0.5% subjects. Swede score was zero in 91%, 1 in 2%, 2 in 6%, and 3 in 1% of subjects. HPE (histopathological examination) was chronic cervicitis in 8.50% and mild dysplasia/CIN 1 in 0.5%. No significant statistical associations between contraceptive choice and false-positive test results or disease prevalence was found in any group except Cu-T users p = 0.0184 (especially for CIN 2; p = 0.0109 and CIN 1 more in all groups than Cu-T users). Colposcopy had sensitivity 100%, specificity 91.46% (0/0 = 0%) PPV = 5.56%, NPV = 100%, Accuracy = 91.5% for detecting mild dysplasia/CIN-non-significant (p = 0.055). Our study had mainly low-grade lesions with 100% NPV. With increase in Swede Score, sensitivity increases but at the expense of specificity but it was statistically non-significant (p = 0.055). Our study may guide the rational use of colposcopy with Swede scoring for see-and-treat lesions, which is easy and with a low learning curve, as a tool for diagnosis but only in cases where indicated like unhealthy cervix because of the high rate of false-positive results. In low-grade lesions, it is highly useful to rule out the disease.

Comparison of Colposcopy and Histopathology in Abnormal Cervix.

Cervicovaginal cancer (CVC) is the most common malignancy of the genital tract. Colposcopy is a diagnostic procedure that is used to examine the cervix and tissue samples of the urethra and vulva in a magnified view. The colposcopy and histological findings of unhealthy cervixes in a tertiary care hospital were compared. This comparative cross-sectional study was conducted from November 2022 to March 2023 among women with a variety of gynecological complaints who visited the Department of Obstetricians and Gynecologists in a tertiary care facility. One hundred participants were included in this study. The data collected were analyzed using Microsoft Excel 2016 (Microsoft Corporation, Redmond, Washington, United States). Participants had an average age of 35.22 ± 7.18 years, and white discharge was the most reported ailment (73%). Comparing the results of the colposcopy with the histological findings revealed a sensitivity of 91.5% and a specificity of 72.2%. The high sensitivity of colposcopy highlights the need to combine it with histological techniques to obtain better results.

A prospective clinical trial of diathermy ablation for patients with high-grade cervical intraepithelial neoplasia from a single institution in Japan

Approximately 500,000 women are diagnosed with cervical cancer annually, with high-grade cervical intraepithelial neoplasia (CIN) estimated to be 20 times higher. The diathermy ablation is an inexpensive minimally invasive surgeries for CIN. However, little is known about the treatment outcomes. A prospective clinical trial was therefore conducted to evaluate ablation outcomes based on detailed colposcopy findings, cytology, and biopsy results over a two-year period. We enrolled CIN2 (n = 32) and CIN3 (n = 7) patients. Eligibility criteria included: aged between 29 and 49 (median: 36, mean: 36.3), visible transformation zone with high-grade lesions not entirely occupying the cervix, and histologically diagnosed with CIN2 or CIN3. Cytology and HPV genotyping were performed, and colposcopic findings were evaluated. Colposcopy-guided diathermy ablation was conducted by a certified gynecologic oncologist. The incidence of recurrent or residual disease was 5.1% (2/39, 95% confidence interval: − 0.02 to 0.12). The prevalence of HPV infection at 12 months decreased after surgery, as 67.6% (23/34, 0.52–0.83) of patients were HPV-negative. No severe adverse events were reported, while there were five pregnancies with full-term deliveries. The promising outcome was possibly due to selection of rigorous surgical indication and skilled surgical techniques. The study highlights the importance of experienced and skilled colposcopists.TrialRegistry This study was registered in the clinical trial registration system of the University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR ID: UMIN000024483). Open for the trial to the public through the website: 01/11/2016. First registration of the patient: 30/01/2017.

The role of endocervical curettage in the diagnosis of cervical intraepithelial neoplasia in human papillomavirus positive patients.

The role of endocervical curettage (ECC) in the diagnosis of cervical intraepithelial neoplasia (CIN) is a controversial topic. Investigate the role of ECC in the diagnosis of CIN in human papillomavirus (HPV) positive patients. Retrospective. A tertiary training and research hospital. This study included patients who were referred for colposcopy between 2018-2022 because of abnormal screening results. ECC results, age, cytology, HPV status, and colposcopic impression of the patients were extracted from the medical records. Multinomial logistic regression analyses were performed to identify factors that could predict CIN on ECC. The likelihood of high-grade squamous intraepithelial lesions (HSIL) in ECC in patients with cervical biopsy results of normal and low-grade squamous intraepithelial lesion (LSIL). 2895 women. In patients with normal and LSIL cervical biopsy results, HSILs were detected in 6.7% of ECC results. There was no difference in the detection rates of CIN in ECC among groups with smear results negative for intraepithelial lesions or malignancy (NILM), atypical squamous cells of undetermined significance (ASC-US), and LSIL. The likelihood of HSIL being observed in ECC was 2.2 times higher in patients with HPV16. The probability of LSIL disanois was 2.3 times higher in women aged 50-59 years and 2.8 times higher in women ≥ 60 years compared to the reference group of <30 years. The probability of LSIL was 2.3 and HSIL by ECC was 2.2 times higher in both age categories (P<.012 and P=.032, respectively) than the reference group of <30 years. Regardless of colposcopic findings, ECC should be performed in patients with smear results of NILM who are positive for HPV16, in patients with smear results of ASC-US and LSIL who are positive for any oncogenic type of HPV and in patients 50 and above with any result of smear or any oncogenic HPV type. We did not have the components of the HPV types in mixed groups.

A research investigation into the micronuclei assay within urothelial cells as an innovative biomarker for the carcinogenesis of cervical cancer conducted at a tertiary care facility

Abstract Background: Cervical carcinoma ranks as the fourth most prevalent cancer in women worldwide, following breast, colorectal, and lung cancers. Screening is a crucial secondary prevention strategy, particularly in developing nations such as India, ensuring effective prevention and treatment. This study investigates the micronuclei assay in urothelial cells as a potential biomarker for cervical carcinoma screening, focusing on its correlation with colposcopic and histopathological observations. Materials and Methods: The prospective study was conducted from September 2016 to September 2017 at the Department of Pathology, Institute of Obstetrics and Gynecology, Madras Medical College, Chennai, Tamil Nadu, India. It involved 108 women who visited the colposcopic clinic. Urine samples were collected from 50 women with normal colposcopic findings and 58 with abnormal colposcopy results. Micronuclei scoring was performed on 1000 epithelial cells from the smears. Additionally, cervical biopsies were conducted for the 58 cases with abnormal colposcopic findings, and the resulting histopathological data were juxtaposed with the findings of the micronuclei assay. Results: The study’s findings demonstrated a sensitivity of 82.76% and a specificity of 90%, with positive predictive values of 90.75% and negative predictive values of 81.82%. Additionally, a statistically significant linear correlation was observed between the micronuclei assay and histopathological diagnosis, with a P value of less than 0.001. Conclusion: Therefore, the micronuclei assay offers a means to detect genotoxicity, monitor cervical carcinogenesis, and identify high-risk groups using simple, reliable, and cost-effective techniques suitable for large-scale screening programs.

Colposcopic biopsy findings in ASCUS or normal cervical cytology patients with high-risk HPV positivity

Colposcopic biopsy findings in ASCUS or normal cervical cytology patients with high-risk HPV positivity