New diagnostic criteria of colposcopy for uterine cervix neoplasia

J Obstet Gynaecol Res. 2017 Feb;43(2):339-344. doi: 10.1111/jog.13199. Epub 2016 Dec 8.

Abstract

Aim: The purpose of this study is to present alternative diagnostic criteria of colposcopy using new parameters.

Methods: Colposcopic photographs were reviewed in 1649 patients from the past 23 years, including 283 benign lesions, 327 low-grade squamous intraepithelial lesions (LSIL; cervical intraepithelial neoplasia 1), 549 high-grade squamous intraepithelial lesions (HSIL; cervical intraepithelial neoplasia 2/3), 78 microinvasive cancers, and 412 invasive cancers. Abnormal colposcopic findings were divided into: minor or major; single, or a combination of two or three findings; and under half or over half circumferential size. Histopathological backgrounds were investigated according to these new parameters of colposcopic findings.

Results: Minor abnormal colposcopic findings were observed in 21% of LSIL, and major abnormal findings were seen in 52% of LSIL, 86% of HSIL, and 86% of microinvasions. A single major abnormal finding was observed in 64% of the cases with LSIL, while two abnormal findings were observed in 43% of HSIL, and three abnormal findings were observed in 44% of microinvasions. In qualifying major abnormal colposcopic findings, under half size was detected in 91% of LSIL and 74% of HSIL, and over half size was observed in 58% of microinvasions. From these results, the following diagnostic criteria were instituted: (i) LSIL - single, minor or major findings and under half size; (ii) HSIL - two or three major findings and under half size; (iii) microinvasion - three major findings and over half size; and (iv) invasive cancer - irregular surface with atypical vessels.

Conclusion: Our new diagnostic criteria of colposcopy are fully acceptable, based on their similar level of accuracy to cytology.

Keywords: colposcopy; diagnostic criteria; uterine cervix neoplasia.

MeSH terms

  • Adult
  • Colposcopy / statistics & numerical data*
  • Female
  • Humans
  • Middle Aged
  • Practice Guidelines as Topic*
  • Uterine Cervical Neoplasms / diagnosis*