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Performance of cytology and colposcopy in diagnosis of cervical intraepithelial neoplasia (CIN) in HIV‐positive and HIV‐negative women
Author(s) -
Branca M.,
Rossi E.,
Alderisio M.,
Migliore G.,
Morosini P. L.,
Vecchione A.,
Sopracordevole F.,
Mudu P.,
Leoncini L.,
Syrjänen K.
Publication year - 2001
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1046/j.1365-2303.2001.00299.x
Subject(s) - colposcopy , medicine , cervical intraepithelial neoplasia , cytology , gynecology , obstetrics , cohort , biopsy , cervical screening , human immunodeficiency virus (hiv) , cervical cancer , pathology , cancer , immunology
Performance of cytology and colposcopy in diagnosis of cervical intraepithelial neoplasia (CIN) in HIV‐positive and HIV‐negative women As part of an extensive multi‐institutional DIANAIDS‐HIV‐HPV‐SIL project run in Italy (co‐ordinated by ISS), the present study compares the performance (sensitivity, specificity, agreement) of routine cervical smear cytology with that of colposcopy in the detection of histologically‐confirmed CIN lesions in 37 HIV‐positive and 21 HIV‐negative women, belonging to the DIANAIDS cohort of 459 women. All women were subjected to a cervical smear, colposcopy and biopsy, making possible the pairwise comparison of these techniques. In the whole series of HIV‐positive and HIV‐negative women, cytology had a sensitivity of 86.9% and specificity of 83.3%, the sensitivity of grade 2 abnormality on colposcopy against histology being 82.6% and specificity, 33.3%. No statistically significant difference was observed in the performance of Pap smears between the HIV‐positive and HIV‐negative women. The sensitivity of cytology was 89.7% vs 82.4% and the specificity, 75% vs 100%. For colposcopy, the sensitivity was 79.3% vs 88.2% and the specificity, 75% vs 50%. These data suggest that cervical Pap smear cytology is a highly sensitive and specific diagnostic tool in the clinical monitoring of lower genital tract pathology in HIV‐positive women. Colposcopy, on the other hand, proved to be a somewhat less accurate diagnostic tool in these women.