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Diagnostic Accuracy of Endocervicoscopy in Identifying and Grading Cervical Intraepithelial Neoplasia Lesion.
- Source :
-
Gynecologic and obstetric investigation [Gynecol Obstet Invest] 2020; Vol. 85 (2), pp. 196-205. Date of Electronic Publication: 2020 Mar 17. - Publication Year :
- 2020
-
Abstract
- Introduction: Colposcopy represents the second step of the diagnostic approach of cervical intraepithelial lesions. Limits of colposcopy in studying cervix are essentially related to cervical anatomy. Nowadays, endocervical courettage is the standard technique to examine endocervix. Endocervicoscopy is a new imaging technique for the diagnostic work-up of endocervix in patients with cervical intraepithelial neoplasia (CIN).<br />Objective: To evaluate endocervicoscopy accuracy to identify and grade cervical intraepithelial lesion in comparison to other procedures employed into the diagnostic workup of cervical pathology.<br />Methods: A total of 634 women who performed colposcopy, endocervicoscopy and cytological or histological sampling were included in a retrospective study. The agreement between the endocervicoscopic and the colposcopic impressions, minor and major changes, and between these imaging techniques and histological diagnosis was assessed for the entire cohort. χ2 test and k statistic were used in the statistical analysis.<br />Results: The extension of the lesion resulted significantly greater at endocervicoscopy than at colposcopy. We showed a statistically significant association between colposcopy and endocervicoscopy findings. Overall, the correlation of minor or major findings between colposcopy and endocervicoscopy was statistically significant with a p value for all parameters <0.0001. Description of mosaic/punctuation, cuffed crypt (gland) openings and ridge sign showed a high k value (k = 0.68 [95% CI 0.64-0.73], k = 0.80 [95% CI 0.75-0.85], k = 0.78 [95% CI 0.64-0.90], respectively). The sensitivity (70.1%) and the specificity (77.0%) of endocervicoscopy for all CIN lesions were lower than colposcopy.<br />Conclusion: Endocervicoscopy turned out to be a good method to identify and grade CIN lesions in a subset of patients where colposcopy was not satisfactory. It allowed us to overcome one of the limits of colposcopy in the evaluation of the squamo-columnar junction and to establish the real extension of the lesion into cervical cancer.<br /> (© 2020 S. Karger AG, Basel.)
- Subjects :
- Adult
Cervix Uteri pathology
Cervix Uteri surgery
Colposcopy methods
Colposcopy statistics & numerical data
Endoscopy methods
Female
Gynecologic Surgical Procedures methods
Humans
Middle Aged
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Uterine Cervical Neoplasms pathology
Uterine Cervical Dysplasia pathology
Endoscopy statistics & numerical data
Gynecologic Surgical Procedures statistics & numerical data
Neoplasm Grading methods
Uterine Cervical Neoplasms diagnosis
Uterine Cervical Dysplasia diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1423-002X
- Volume :
- 85
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Gynecologic and obstetric investigation
- Publication Type :
- Academic Journal
- Accession number :
- 32182612
- Full Text :
- https://doi.org/10.1159/000506801