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Evaluation of women presenting with postcoital bleeding by cytology and colposcopy
Author(s) -
Tehranian Afsaneh,
Rezaii Negar,
Mohit Mitra,
Eslami Bita,
Arab Malihe,
Asgari Zahra
Publication year - 2009
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2008.12.006
Subject(s) - colposcopy , medicine , cervical intraepithelial neoplasia , cytology , gynecology , histopathology , cervical cancer , obstetrics , cancer , pathology
Objective To evaluate women with postcoital bleeding (PCB) by clinical examination, cytology, colposcopy, and histopathology. Methods A cross‐sectional study of 123 women with PCB, who were referred to the Colposcopy Clinic of Arash Hospital, Tehran, over a 2‐year period. Results Clinical examinations revealed cervical polyps in 18 women and ectropion in 14. Cervical cytology identified 13 patients with atypical squamous cells of undetermined significance, 2 with atypical glandular cells, 4 with low‐grade squamous intraepithelial lesions, and 3 with high‐grade squamous intraepithelial lesions. Colposcopy indicated invasive cancer in 1 patient. Transitional zones appeared normal in 39.8% of the cohort, were atypical grade 1 in 33.3%, and atypical grade 2 in 4.9%. Fourteen abnormalities were detected at histology, including 1 squamous cell carcinoma, 1 low‐grade glandular neoplasm, 9 cervical intraepithelial neoplasia (CIN) grade 1, 2 CIN grade 2, and 1 CIN grade 3. The sensitivity and specificity of cytology were 50% and 86.5%, respectively. A total of 21.4% of abnormal pathologies were missed using colposcopy, which had a sensitivity of 79%. Conclusion Because of its higher sensitivity, colposcopy can be recommended for the investigation of persistent PCB, even in the presence of normal cytology.