Colposcopic characteristics of high-risk human papillomavirus-related cervical lesions

J Low Genit Tract Dis. 2010 Jan;14(1):49-55. doi: 10.1097/LGT.0b013e3181b0fb8e.

Abstract

Objective: Because high-risk human papillomavirus (hrHPV) is the necessary factor in the development of high-grade cervical lesions, knowing the colposcopic differences between hrHPV-positive and hrHPV-negative lesions could be of value. We have evaluated whether there are colposcopic differences between lesions testing hrHPV-positive or hrHPV-negative.

Materials and methods: This study was conducted as a retrospective case-control study. We designed a scoring system for colposcopic criteria that might be of relevance to distinguish hrHPV-positive from hrHPV-negative lesions. Colposcopic images were analyzed from patients at the VU University Medical Center Amsterdam, the Netherlands, in whom a GP5+/6+ polymerase chain reaction hrHPV test had been performed within a month of the colposcopic examination (n = 507).

Results: Visibility of the transformation zone (corrected for age), a (very) coarse and irregular punctation pattern, and a large lesion (>25% of the visible cervix) were more often associated with a positive hrHPV test status (p =.001, odds ratio [OR] = 2.29, 95% CI = 1.41-3.73; p =.036, OR 2.37, 95% CI = 1.08-5.19; and p =.044, OR = 1.78, 95% CI = 1.08-2.94, respectively). After correction for histologic diagnosis, the difference between hrHPV-positive and hrHPV-negative lesions for visibility of the transformation zone and lesion size remained statistically significant (OR = 2.44, 95% CI = 1.35-4.41 and OR = 1.92, 95% CI = 1.04-3.54, respectively).

Conclusions: This study indicates that visibility of the transformation zone, (very) coarse punctation pattern, and larger lesion size were the main colposcopic features associated with a hrHPV-positive test status.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Case-Control Studies
  • Colposcopy*
  • DNA, Viral / genetics
  • DNA, Viral / isolation & purification
  • Female
  • Humans
  • Middle Aged
  • Netherlands
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / pathology*
  • Polymerase Chain Reaction / methods
  • Retrospective Studies
  • Severity of Illness Index
  • Uterine Cervical Diseases / diagnosis*
  • Uterine Cervical Diseases / pathology*
  • Young Adult

Substances

  • DNA, Viral