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Colposcopic scoring indexes in the evaluation of cervical lesions with the cytological result of atypical squamous cells, cannot exclude high‐grade lesion
Author(s) -
Kudela Erik,
Laucekova Zuzana,
Nachajova Marcela,
Visnovsky Jozef,
Bielik Tibor,
Krivus Stefan,
Biringer Kamil,
Balharek Tomas,
Zubor Pavol
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14158
Subject(s) - medicine , colposcopy , squamous intraepithelial lesion , cervix , dysplasia , cutoff , likelihood ratios in diagnostic testing , gynecology , exact test , obstetrics , radiology , cervical cancer , cervical intraepithelial neoplasia , diagnostic accuracy , cancer , physics , quantum mechanics
Aim Colposcopic indexes including Reid index and Swede score were developed to make the colposcopy more objective. The aim of our study was to evaluate the significance of colposcopic indexes in the evaluation of ASC‐H cervical lesions. Methods We carried out a cross‐sectional study in the Clinic of Obstetrics and Gynecology between January 2013 and December 2018. The study included 535 women, from which 66 women had a cytological result ASC‐H. Scoring of all colposcopic findings was assessed according to Reid modified index and Swede score and a composite score was determined. Frequency distributions were compared using χ 2 /Fisher exact test. Spearman rank correlation coefficient was computed between RCI and Swede score. Results Sensitivity, specificity, positive and negative predictive value and positive likelihood ratio of modified Reid colposcopic index at a cutoff of ≥4 for the detection of HSIL+ lesions were: 86.11% (95% CI: 70.5–95.3), 83.33% (95% CI: 65.3–94.4), 86.11% (95% CI: 69.7–94.8), 83.33% (95% CI: 64.5–93.7) and 5.17 (95% CI: 2.3–11.6). Swede score with the cutoff value ≥5 showed comparable results to modified Reid index with the increased sensitivity: 94.44% (95% CI: 81.3–99.3). Conclusion ASC‐H category represents the trickiest cytological diagnosis as it is underlined with the high risk of severe cervical dysplasia. Evaluating the cervical lesion by the use of colposcopic indices helps the gynecologist to objectively evaluate all the pathologies of uterine cervix. Swede score with the cutoff value 8 also enables a ‘see and treat’ option in management of atypical squamous cells, cannot exclude high‐grade lesions.