Diagnosis Of Cervical Lesions Research Articles

Analysis of factors affecting the accuracy of colposcopic diagnosis of cervical lesions: a retrospective cohort study.

Cervical cancer is a leading cause of cancer-related deaths among women. However, in developing countries, the primary focus for cervical cancer prevention and control remains on the timely detection and treatment of precancerous lesions. This study aims to evaluate the accuracy of colposcopic diagnosis of cervical intraepithelial lesions and analyze the factors influencing its accuracy. This study collected data from 512 eligible patients who visited the gynecology outpatient clinic of the Second Hospital of Jilin University from January 2022 to August 2023. The final diagnosis was based on the highest grade observed in both biopsy pathology and postoperative pathology. A self-controlled, retrospective analysis was conducted to evaluate the accuracy of colposcopic diagnosis. Univariate analysis was used to assess the impact of factors such as menopausal status, duration of menopause, high-risk human papillomavirus (HR-HPV) genotypes, and transformation zone (TZ) types on the accuracy of colposcopic diagnosis of cervical lesions. The overall colposcopy diagnostic concordance rate was 78.71%. The concordance rates between the premenopausal and postmenopausal groups differed significantly (χ 2 = 75.450, p < 0.05). The HPV16/18 positive group and the non 16/18 HR-HPV positive group also showed a significant difference in concordance rates (χ 2 = 5.890, p < 0.05). There were significant differences in concordance rates between TZ2 and TZ3 (χ 2 = 10.585, p < 0.05), as well as between TZ1 and TZ3 (χ 2 = 14.607, p < 0.05). Factors such as menopausal status, duration of menopause, HR-HPV genotypes, and TZ types influence the accuracy of colposcopic diagnosis. Therefore, a comprehensive evaluation incorporating these factors should be performed in clinical practice to enhance diagnostic accuracy.

Diagnostic Agreement in Whole Slide Digital Images ofCervical Cytology and Cell Blocks.

Cell blocks (CB) are an established technique in non-gynecological cytology, but experience in gynecological cytology is still relatively limited. In this study, we compared the diagnostic agreement between liquid-based cytology (LBC) and CB using whole slide digital imaging (WSI). WSI of 82 specimens (41 LBC and 41 CB) were evaluated independently by three observers. The overall agreement was 0.463 for all 82 cases including both LBC and CB, 0.439 for LBC alone, and 0.484 for CB alone. Agreement was highest for HSIL, NILM, cancers and lower for borderline (ASC-US, ASC-H). There was no significant difference in agreement between LBC and CB. WSI of CB can be used for the diagnosis of cervical lesions and may be particularly useful in cases with high atypical cellularity or large hyperchromatic cell groups.

Improving the effectiveness of cervical cancer screening: Managing positive high-risk human papillomavirus results.

Good compliance of the management of abnormal results is important for effective cervical screening. This study investigated the rate of surveillance and follow-up outcomes for human papillomavirus (HPV)-positive women in cervical screening. Women on surveillance by repeat HPV testing were identified in a prospectively managed database. Data retrieved included women's age, country residence status, history of colposcopy, HPV-DNA status on the first and repeat tests, dates of follow-up during the 5 years since the initial screening, and histological diagnosis of cervical lesions. The main outcome measures were compliance rate for repeat HPV testing, regression and persistence rates of HPV subtypes, and detection rate of high-grade lesions (CIN2+). This analysis included 680 residents in the community, mean age 44.8 (95% confidence interval 20.1-69.5) years. The compliance rate of repeat testing was 28.2% at 12 months and, cumulatively, 42.8% for the entire 5-year follow-up period. The rates were unaffected by age (P=0.5829) nor prior colposcopy (P=0.1607). There were 5 (1.7%) cases of CIN2+ detected. Of 391 women on longitudi-nal follow-up, 194 (60.8%) cleared their HPV infection. Some women with multiple HPV infection cleared 1 but not the other subtype(s). Thus, the regression rate was 90.3% for HPV-16, 87.0% for HPV-18 and 65.2% for HPV-12-others (P=0.001). The annualised HPV regression rates were similar for HPV subtypes and for each follow-up year. Surveillance of HPV positivity is clinically important for detecting high-grade lesions. Despite a high regression rate of HPV, surveillance hesitancy is a serious weakness in routine cervical screening.

Clinical analysis of DNA methylation in the diagnosis of cervical lesions

Clinical analysis of DNA methylation in the diagnosis of cervical lesions

Significance of negative cervical cytology and positive HPV in the diagnosis of cervical lesions by colposcopy.

The aim of this study was to investigate the significance of colposcopy in diagnosing cervical lesions when negative cervical cytology is combined with positive human papillomavirus (HPV). Overall, 370 patients with cervical epithelial lesions who had negative cervical fluid-based cytology combined with positive HPV results were selected and analysed for severity of cervical lesions and HPV distribution. Among the patients with cervical lesions, 242 had a single HPV infection, and 128 cases had multiple infections. No significant difference was found between HPV single infection and multiple infections in both groups of patients with cervical lesions (P > 0.05). Furthermore, 137 had non-HPV 16 and 18, accounting for 37.30% of all the patients with cervical lesions. Among them, HPV 52, 58, and 33 infections were the most common at 38.69, 30.66 and 29.20%, respectively - significantly higher than other high-risk HPV types (P < 0.05). High-risk HPV testing is crucial in patients with negative cervical fluid-based cytology combined with positive HPV results. Patients with HPV 16 and 18 and those with simple HPV 52, 58, and 33 infections should undergo timely colposcopy.

Pathological Changes and Pregnancy Outcomes in Cervical Intraepithelial Neoplasia Patients After Cold Knife Conization.

Analyze women treated with underwent cold knife conization (CKC) to remove advanced squamous intraepithelial lesions (CIN) of the cervix. The histopathological upgrading of the lesions previously detected on vaginal biopsy and postoperative pregnancy outcomes of were investigated, to identify high-risk subgroups in women. A retrospective study was conducted at the First Central Hospital of Baoding City from June 2019 to December 2022 to analyze confirmed cases of Cervical Intraepithelial Neoplasia CIN-II and CIN-III. Investigation of pathological changes in postoperative pathological tissues, and to perform binary logistic analysis to identify risk factors for histopathological escalation in postoperative lesions. We analyze the effects of CKC surgery on pregnancy outcomes in patients by comparing against a control group of healthy pregnant women. Out of the 176 patients diagnosed with CIN-II who underwent cervical biopsy, 39 (22.16%) were found to have a final specimen diagnosis of CIN-III, while 7 (3.98%) were downgraded to CIN-I. Among the 108 patients diagnosed with CIN-III who underwent cervical biopsy, 7 cases (6.48%) were ultimately confirmed to have CIN-III. Ki67-positive, p16-positive (OR = 1.13, 95% CI 1.01-1.15), and colposcopy biopsy for CIN-II (OR = 1.59, 95% CI 1.33-3.6) were independent risk factors for pathological upgrade after CKC. Compared with healthy pregnant women, CIN patients had higher rates of premature birth (14.4%), premature rupture of the fetal membrane (13.6%), and cesarean section (37.5%) (P < 0.05). The mode of conception, abortion rate, ectopic pregnancy rate, and postpartum hemorrhage were not different between healthy pregnant women and CIN patients (P > 0.05). Following cervical multi-point biopsy or CKC, along with pathological examination, the accurate diagnosis of cervical lesions is crucial as it allows for more precise identification of such lesions. Additionally, CKC increases the risk of premature birth, premature rupture of membranes, and the need for cesarean section.

Application of HPV-16 in Liquid-Based thin Layer Cytology of Host Genetic Lesions Based on AI Diagnostic Technology Presentation of Liquid

Nowadays, with the continuous improvement of people's health awareness and the increasing incidence of cancer year by year, the screening work of various clinical diseases, especially cancer, is also widely promoted. Cervical lesion screening is a common type. Cervical lesion screening is used to judge whether women have cervical lesions and increase attention to cervical lesions[1]. Proper prevention, diagnosis and treatment play an important role in ensuring women's health and life safety, and have been widely promoted in many places in our country. At the same time, in the screening of cervical lesions, how to adopt a more efficient and accurate diagnosis is very important to improve the screening effect of cervical lesions. With the rapid development of science and technology, AI and other advanced technologies have been gradually introduced in clinical disease diagnosis, especially in the liquid-based thin-layer cytology examination[2]. To further analyze the application effect of liquid based thin layer cytology AI diagnostic technology in the pathological diagnosis of cervical lesions. In this paper, we investigate the occurrence of HPV-16 integrated human host genome in cervical cancer and precancerous lesions and its application in cervical cancer screening. 50 cases of cervical cancer, 127 cases of LSIL, 83 cases of HSIL were collected, in addition, 22 cases of normal cervical epithelial tissues extracted by total hysterectomy were collected. The integration status of HPV-16 infection was detected by overlapping PCR.

Cytomorphological study of pap smear and its efficacy to detect various cervical lesions

: Cervical lesions require screening for early diagnosis to differentiate between non-neoplastic and neoplastic lesions of cervix. The present research aimed to evaluate the prevalence of various cervical lesions and detect the efficacy as a screening test of pap smear for early diagnosis of cervical lesions. : The current retrospective study was conducted in the Department of Pathology, SSMC, Rewa, M.P. Total 658 cervical pap smears were retrieved, re-examined and re-classified according to the revised Bethesda system for reporting of cervical cytology, 2014. Out of 658 pap smears, 234 biopsies were available, which were re-examined histopathologically and correlation was done with their corresponding cytological findings.: Out of 658 pap smears, negative for intraepithelial lesion or malignancy (NILM) was found in 74.47% smears, while the prevalence of epithelial cell abnormalities (ECA) was 24.32%. Amongst ECA, most common (11.86%) cervical lesion was low-grade squamous intraepithelial lesion (LSIL). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for the diagnosis of pre-invasive and invasive cervical lesions was found 70.54%, 81.9%, 82.72%, 69.35% and 75.6% respectively.: The current study showed that pap smear cytology is able to detect various cervical lesions with a diagnostic accuracy of 75.6%. So, women belonging to reproductive or postmenopausal age-group should be routinely screened for cervical lesions by non-invasive pap smear method. Conclusively, early diagnosis of cervical lesions is possible, thus reducing the incidence of invasive cervical carcinoma.

Extraovarian Dysgerminoma Involving the Uterine Cervix: A Rare Case Report With Literature Review.

Primary extraovarian dysgerminoma (EOD) is a very rare disease. There is no literature about primary EOD involving the uterine cervix. We herein present details of a unique case of primary EOD involving the uterine cervix. A 46-year-old woman with uterine cervical tumor was referred to our institution with atypical genital bleeding. A polypoid tumor localized to the uterine cervix was found. Cervical biopsy detected malignant components of likely nonepithelial cell origin. Preoperative imaging examinations showed a uterine cervical tumor measuring ~5cm, suggestive of malignancy without distant or lymph node metastases. The patient underwent abdominal radical hysterectomy with pelvic lymph node dissection according to the standard treatment for stage IB3 cervical cancers. The pathological diagnosis was dysgerminoma involving the uterine cervix and the right fallopian tube. Immunohistochemical results were as follows: SALL4 (+), octamer-binding transcription factor 4 (+), D2-40 (+), and c-Kit (+). She received 3 cycles of adjuvant chemotherapy with bleomycin, etoposide, and cisplatin. The disease did not recur up to 14 months after surgery. This is the first-ever published case of primary EOD involving the uterine cervix among previously reported EOD cases. Reported cases of EOD in female genital tracts are also reviewed. Our case provides more extensive insights for pathologists to consider the differential diagnosis of cervical lesions. In our case, combination therapy involving a surgical approach-according to cervical cancers and adjuvant chemotherapy as used for ovarian dysgerminomas-was effective. Future verification is needed regarding the best approach for treating uterine cervical dysgerminomas.

Microendoscopy in vivo for the pathological diagnosis of cervical precancerous lesions and early cervical cancer

BackgroundCervical cancer is an important public health problem. Conventional colposcopy is inefficient in the diagnosis of cervical lesions and massive biopsies result in trauma. There is an urgent need for a new clinical strategy to triage women with abnormal cervical screening results immediately and effectively. In this study, the high-resolution microendoscopy combined with methylene blue cell staining technology was used to perform real-time in vivo imaging of the cervix for the first time.MethodsA total of 41 patients were enrolled in the study. All patients underwent routine colposcopy and cervical biopsy, and high-resolution images of methylene blue-stained cervical lesions were obtained in vivo using microendoscopy. The cell morphological features of benign and neoplastic cervical lesions stained with methylene blue under microendoscopy were analyzed and summarized. The microendoscopy and histopathology findings of the high-grade squamous intraepithelial lesion (HSIL) and more severe lesions were compared.ResultsThe overall consistency of microendoscopy diagnosis with pathological diagnosis was 95.12% (39/41). Diagnostic cell morphological features of cervicitis, low-grade squamous intraepithelial lesion (LSIL), HSIL, adenocarcinoma in situ, and invasive cancer were clearly demonstrated in methylene blue stained microendoscopic images. In HSIL and more severe lesions, microendoscopic methylene blue cell staining technology can show the microscopic diagnostic features consistent with histopathology.ConclusionsThis study was an initial exercise in the application of the microendoscopy imaging system combined with methylene blue cell staining technology to cervical precancerous lesions and cervical cancer screening. The results provided the basis for a novel clinical strategy for triage of women with abnormal cervical screening results using in vivo non-invasive optical diagnosis technology.

The Value of Immunocytochemical Staining for the HPV E7 Protein in the Diagnosis of Cervical Lesions.

To investigate the value of immunocytochemical (ICC) staining for human papillomavirus (HPV) E7 protein (E7-ICC staining) as a new-generation immunological method in the cytological diagnosis of cervical lesions. The exfoliated cervical cell samples of 690 women were subjected to a liquid-based cytology test (LCT), high-risk HPV (HR-HPV) test, E7-ICC staining, and cervical biopsy for pathological diagnosis. E7-ICC staining as a preliminary screening scheme for cervical precancerous lesions was comparable to the HR-HPV test in sensitivity and to the LCT in specificity. E7-ICC staining was advantageous in facilitating the secondary triage of HR-HPV-positive patients; therefore, this method can be used as an auxiliary scheme to routine LCT for diagnostic grading to improve the accuracy of cervical cytology. E7-ICC staining as a primary or auxiliary cytological screening scheme can effectively reduce the colposcopy referral rate.

Application of EfficientNet-B0 and GRU-based deep learning on classifying the colposcopy diagnosis of precancerous cervical lesions.

Colposcopy is indispensable for the diagnosis of cervical lesions. However, its diagnosis accuracy for high-grade squamous intraepithelial lesion (HSIL) is at about 50%, and the accuracy is largely dependent on the skill and experience of colposcopists. The advancement in computational power made it possible for the application of artificial intelligence (AI) to clinical problems.Here, we explored the feasibility and accuracy of the application of AI on precancerous and cancerous cervical colposcopic image recognition and classification. The images were collected from 6002 colposcopy examinations of normal control, low-grade squamous intraepithelial lesion (LSIL), and HSIL. For each patient, the original, Schiller test, and acetic-acid images were all collected. We built a new neural network classification model based on the hybrid algorithm. EfficientNet-b0 was used as the backbone network for the image feature extraction, and GRU(Gate Recurrent Unit)was applied for feature fusion of the three modes examinations (original, acetic acid, and Schiller test). The connected network classifier achieved an accuracy of 90.61% in distinguishing HSIL from normal and LSIL. Furthermore, the model was applied to "Trichotomy", which reached an accuracy of 91.18% in distinguishing the HSIL, LSIL and normal control at the same time. Our results revealed that as shown by the high accuracy of AI in the classification of colposcopic images, AI exhibited great potential to be an effective tool for the accurate diagnosis of cervical disease and for early therapeutic intervention in cervical precancer.

The importance of HPV types and endocervical curettage in colposcopic examination for the diagnosis of cervical lesions

The importance of HPV types and endocervical curettage in colposcopic examination for the diagnosis of cervical lesions

Histopathological Study of Spectrum of Lesions of Uterine Cervix.

Uterine cervix is a gateway to several neoplastic and nonneoplastic lesions. Cervical carcinoma accounts for 20%-25% of all cancers and 80%-85% of all genital tract cancers worldwide. It is the most common malignancy in Indian women. The aim of this study was to study the histopathological spectrum, incidence, and distribution with respect to the age of various cervical lesions and to determine their clinicopathological correlation. A prospective observational study of 200 cases of cervical lesions was carried out in the histopathology section of the Department of Pathology for the duration of 2 years after obtaining permission from the Institutional Ethics Committee. Study participants were selected from the study population admitted at the study center based on the inclusion and exclusion criteria. Statistical software GraphPad InStat.v3.0 was used for statistical analysis. In our study, 49.5% of cases were malignant and 50.5% of cases were benign. The most common malignant lesion on histopathological examination was squamous cell carcinoma (SCC). Majority of the lesions were in the 41-50 years of age group. Clinicopathological agreement was noted in 93.5% of cases. Twenty-eight out of 30 cases of SCC (93.33%) were positive for p16 staining. Agreement between Pap smear findings and histopathological diagnosis was 100% in cases of malignant and premalignant lesions of the cervix. Histopathological examination is important not only for confirmation of the preoperative diagnosis but also in evaluating the incidence and age-wise distribution of both neoplastic and nonneoplastic cervical lesions. Early and accurate diagnosis of cervical lesions provides an opportunity for appropriate interventions to prevent further complications.

Relationship Between Immunohistochemical CD3, CD4, CD5, CD8, and PD1 Staining and Histopathological Diagnosis of Cervical Lesions in Patients With Abnormal Colposcopic Findings.

This study aimed to analyse the relationship between clinicopathological factors in cervical intraepithelial lesions and abnormal colposcopic findings. Thirty high-grade squamous intraepithelial lesion (HSIL) and thirty low-grade squamous intraepithelial lesion (LSIL) patients who underwent biopsy due to abnormal colposcopic findings were included in the study. The immunoreactivity of CD3, CD4, CD5, CD8, and PD-1 was analysed immunohistochemically in tumor-infiltrating lymphocytes (TILs) and stromal lymphocytes. In TILs, CD3, CD4, CD5, CD8, and PD-1 were highly stained in 20/30 (66.6%), 16/30 (53.3%), 15/30 (50.0%), 24/30 (80.0%), and 13/30 (43.3%) of the cases for the HSIL group, while 7/30 (23.3%), 4/30 (13.3%), 5/30 (16.6%), 9/30 (30.0%), and 5/30 (16.6%) were in the LSIL group, respectively. CD3, CD4, CD5, CD8, and PD-1 immunostainings for TILs were higher in the HSIL group (p=0.001, p=0.001, p=0.006, p˂0.001, p=0.024, respectively). Only PD-1 was significantly higher in lymphocytes in the stroma (p=0.001). CD3, CD4, and CD8 also show a positive correlation with the Ki-67 proliferation index. CD3, CD4, CD5, and CD8 may contribute to PD-1-mediated tumour control. Immunohistochemical staining plays a key role in evaluating the tumour microenvironment.

Classification and diagnosis of cervical lesions based on colposcopy images using deep fully convolutional networks: A man-machine comparison cohort study

Colposcopy is an important technique in the diagnosis of cervical cancer. The development of computer-aided diagnosis methods can mitigate the shortage of colposcopists and improve the accuracy and efficiency of colposcopy examinations in China. This study proposes the Dense-U-Net model for colposcopy image recognition. This was a man–machine comparison cohort study. It presents a novel artificial intelligence (AI) model for the diagnosis of cervical lesions through colposcopy images using a Dense-U-Net image semantic segmentation algorithm. The Dense-U-Net model was created by applying the methods of “deepening the network structure,” “applying dropout” and “max pooling.” Moreover, image-based and population-based diagnostic performances of the AI algorithm and physicians with different levels of specialist experience were compared. In total, 2,475 participants were recruited, and 13,084 colposcopy images were included in this study. The diagnostic accuracy of the Dense-U-Net model increased significantly with increasing colposcopy images per patient. As the number of images in the training set increased, the diagnostic accuracy of the Dense-U-Net model for cervical intraepithelial neoplasm 3 or worse (CIN3+) diagnosis increased (P = 0.035). The rate of diagnostic accuracy (0.89 vs 0.85, P<0.001) of CIN3+ lesions using the Dense-U-Net model was higher than that of expert colposcopists, and the missed diagnosis (0.06 vs 0.07, P = 0.002) and false positive (0.05 vs 0.08, P<0.001) were lower. Moreover, Dense-U-Net is more accurate in diagnosing the type III cervical transformation zone, which is difficult to diagnose by experts (P<0.001). The Dense-U-Net model also showed higher diagnostic accuracy for CIN3+ in an independent test set (P<0.001). To diagnose the same 870 test images, the Dense-U-Net system took 1.76 ± 0.09 min, while the expert, senior, and junior colposcopists took 716.3 ± 49.76, 892.1 ± 92.30, and 3034.7 ± 259.51 min, respectively. The study successfully built a reliable, quick, and effective Dense-U-Net model to assist with colposcopy examinations.

A STUDY OF VIA AND VILI AS A CERVICAL CANCER SCREENING METHOD

Introduction: As per globocan 2020, 604100 new cases of cervical cancer were detected worldwide in 2020, and 341831 deaths were there due to this malignancy. About 90% of these cases are found in low and middle-income countries. Cervical cancer is the only female genital tract cancer which can be diagnosed and treated in precancerous state by simple screening techniques. VIA/VILI are cheap and noninvasive methods and can be done in a low-level health facility. More importantly, VIA and VILI provide instant results, and those eligible for treatment of the precancerous lesions can be treated immediately. This retrospective study Material And Methods: was carried out in a Gynecology clinic in district Shivpuri M.P. From 1 April 2019 to 31 march 2022. 450 patients were studied. A detailed history regarding name, age, residence, socio-economic status, parity, any previous study, and any allergy was enquired. All ndings of VIA and VILI-positive cases were carefully documented in the proforma. In this study visual inspection of the cervix was done in 450 cases and 59 biopsy specimens were sent. In this study most of the patients were between 21-40 ye Results: ars of age (40%), multipara (74.88%), of low socioeconomic background (50.66%), and most of them were from rural areas (64%). The most common presenting symptom was excessive vaginal discharge (58.88%) followed by abnormal bleeding (13.11%). (13.11%) cases were VIA positive and (10.44%) cases were both VIA/VILI positive. Biopsy was taken from 59 patients who were VIA positive, this test detected 5.55% (25 patients) of CIN I, 2% (9 patients) of CIN II, 1.77% (8 patients) of CIN III, and 0.22% (1 patient) cases of squamous cell carcinoma. W Conclusion: e found that VIA and VILI can be adopted as screening tools for the diagnosis of cervical lesions. Result and follow-up treatment can be provided in a single sitting hence fewer women are lost to follow-up.

CTIFI: Clinical-experience-guided three-vision images features integration for diagnosis of cervical lesions

At present, the research on diagnosis of cervical lesions based on deep learning mostly uses single-vision images or full-mixed images, ignoring the correlation among the three-vision images in the clinic, so that the effect is not good and the help to clinicians is extremely limited. Therefore, according to the guidance of clinical experience, this paper proposes a novel method of three-vision images features integration (CTIFI) for the classification and diagnosis of cervical lesions by simultaneously performing feature learning on three-vision images of the same patient. Firstly, SE-DenseNet is used to extract the features from three-vision cervical images. During this process, the invalid features are suppressed while the network is concentrated to important features. Then, the three-vision images features are integrated to effectively improve the performance of lesion classification. Under the same study conditions, this method was compared with other methods and clinicians. The results show that the accuracy (ACC) and the area under the curve (AUC) of this method were 71% and 0.876, which are superior to the average level of other methods and clinicians. Therefore, it can help clinicians make diagnosis, reduce misdiagnosis and missed diagnosis, so as to improve work efficiency.

Non-Invasive Differential Diagnosis of Cervical Neoplastic Lesions by the Lipid Profile Analysis of Cervical Scrapings

Cervical cancer is one of the most common cancers in women with pronounced stages of precancerous lesions. Accurate differential diagnosis of such lesions is one of the primary challenges of medical specialists, which is vital to improving patient survival. The aim of this study was to develop and test an algorithm for the differential diagnosis of cervical lesions based on lipid levels in scrapings from the cervical epithelium and cervicovaginal canal. The lipid composition of the samples was analyzed by high-performance chromato-mass spectrometry. Lipid markers were selected using the Mann–Whitney test with a cutoff value of 0.05 and by projections to latent structures discriminant analysis, where a projection threshold of one was chosen. The final selection of variables for binomial logistic regressions was carried out using the Akaike information criterion. As a result, a final neoplasia classification method, based on 20 logistic regression sub-models, has an accuracy of 79% for discrimination NILM/cervicitis/LSIL/HSIL/cancer. The model has a sensitivity of 83% and a specificity of 88% for discrimination of several lesions (HSIL and cancer). This allows us to discuss the prospective viability of further validation of the developed non-invasive method of differential diagnosis.

Diagnostic utility of pap smear and visual inspection of acetic acid for the detection of various cervical lesions

Background: Cervical cancer is one of the leading causes of death among women facing gynecological problems. It requires early detection by various screening methods. Aims and Objectives: The current research aimed to assess the diagnostic utility of pap smear cytology and visual inspection of acetic acid (VIA) as a screening test for various cervical lesions. Materials and Methods: The current prospective study was conducted on 210 non-pregnant women. Cervical pap smears were taken and reported according to the revised Bethesda system, 2014. VIA examination was also done, and any dense opaque aceto-white lesion observation near the squamo-columnar junction was reported as VIA positive. The findings of pap smear cytology and VIA were correlated with findings of histopathology. Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of pap smear cytology for the diagnosis of cervical lesions were found to be 90.16%, 85.22%, 89.43%, 86.2%, and 88.09%, respectively; while sensitivity, specificity, PPV, NPV, and diagnostic accuracy of VIA for the diagnosis of cervical lesions were found to be 88.37%, 55.55%, 76%, 75%, and 75.71%, respectively. Our study showed a substantial degree of agreement between pap smear cytology and histopathology for the diagnosis of cervical lesions with Cohen’s kappa value being 0.755. Conclusion: The current study revealed that pap smear and VIA have high sensitivity with good diagnostic accuracy for the detection of neoplastic cervical lesions, which indicate that they can be used as an efficient screening tool for the detection of cervical lesions in their earlier stages.