DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20221431

Findings from colposcopy and colposcopy directed biopsy in cervical precancerous lesions

Sulekha Bhattacharjee, Khadiza Begum, Priyanka Waddader, Supran Biswas

Abstract


Background: Pap smear test has been less successful in identifying those women with the highest risk for pre-malignant disease, so the patients with equivocal Pap smear would need further evaluation with colposcopy. Performing the colposcopy with more accuracy would result in better prognosis of pre-malignant lesions. However, performing a comparison with directed biopsy is required to obtain more definite results. The aim of this study was to determine colcoscopic findings in VIA positive cases.

Methods: This observational study was conducted at the Department of Gynaecology and Obstetrics in Chittagong Medical College Hospital, Chittagong from September 2014 to February 2015. A total 72 women of VIA positive cases attended at colposcopy clinic of CMCH were included in this study. These patients were selected nonrandomly according to inclusion criteria. All patients were sign a written informed consent before recruitment into the study. According to colposcopy diagnosis was done by Reid colposcopic index. All patients were undergone directed biopsy followed by histopathology. Data were collected under guidance and advice of the supervisor through a structured questionnaire.

Results: Almost two-thirds of the cases were 30-39 years age group. Among the 72 cases the presentations were mainly excessive vaginal discharge 61.1%, dyspareunia 16.7%, post-coital bleeding 9.7% and abnormal inter-menstrual bleeding 12.5%. Colposcopically 90.3% had CIN and invasive lesions, while 9.7% was normal. Colposcopically directed punch biopsy revealed in 84.7% cases positive lesions and 15.3% had not any CIN or invasive lesions.

Conclusions: This study demonstrated high accuracy. Sensitivity is lower in our studies, probably because biopsies were performed in all cases.


Keywords


Colposcopy findings, Histopathology, Biopsy, Cervical pre-cancerous lesions

Full Text:

PDF

References


Alphs HH, Wu TC, Roden RBS. Prevention and treatment of cervical cancer by vaccination. In: Bovicelli A, Giordano A, Kurman RJ (eds). Molecular pathology of gynecology cancer. New Jersey: Humana Press; 2007:124-54.

Sellors JW, Sankaranarayanan R, Colposcopy and treatment of cervical intraepithelial neoplasia: a beginners’ manual. Lyon: IARC Press; 2003:13-21.

Reagan JW, Seidemann IL, Saracusa Y, The cellular morphology of carcinoma in situ and dysplasia or atypical hyperplasia of the uterine cervix. Cancer. 1953;6(2):224-34.

Richart RM, Natural history of cervical intraepithelial neoplasia. Clin Obstet Gynecol. 1967;10(4):748-84.

Richart RM, A modified terminology for cervical intraepithelial neoplasia. Clin Obstet Gynecol. 1990; 75(1):131-3.

World Health Organization, Pan-American Health Organisation. Visual Inspection of the Uterine Cervix with Acetic Acid (VIA): A Critical review Geneva, Switzerland. Available at: https://www.paho.org/. Accessed on 20 November 2021.

Rosenthal AN, Panoskaltsis T, Smith T, Soutter WP. The frequency of significant pathology in women attending a general gynaecological service for postcoital bleeding. BJOG: Int J Obstet Gynaecol. 2001;108:103-6.

Ahmed T, Ashrafunnessa, Rahman J. Development of a visual inspection programme for cervical cancer prevention in Bangladesh. Reprod Health Matters. 2008;16:78-85.

Khatun S, Akram Hussain SM, Chowdhury S, Ferdous J, Hossain F, Begum SR, Jahan M, Tabassum S, Khatun S, Karim AF. Safety and immunogenicity profile of human papillomavirus-16/18 AS04 adjuvant cervical cancer vaccine: a randomized controlled trial in healthy adolescent girls of Bangladesh. Japanese J Clin Oncol. 2011;42:36-41.

Nessa A, Hussain MA, Rahman JN, Rashid MH, Muwonge R, Sankaranarayanan R. Screening for cervical neoplasia in Bangladesh using visual inspection with acetic acid. Int J Gynecol Obstet. 2010; 111:115-8.

Ancuta B. Correlations between colposcopy and histologic results from colposcopically directed biopsy in cervical precancerous lesions. Rom J Morphol Embryol. 2012;53(3):735-41.

Dorji N, Begum SA, Mahmud T, Amatullah M. Evaluation of Colposcopic and Histopathological Findings in Precancerous Cervical Lesions. Bangladesh Med Res Counc Bull. 2020;46:48-54.

Boonlikit S, Correlation between Reid’s colposcopic index and histologic results from colposcopically directed biopsy in differentiating high-grade from low-grade squamous intraepithelial lesion at Rajavithi Hospital. Med Assoc Thai. 2011;94(2):S59-S65.

Maziah AM, Sharifah NA, Yahya A, Comparative study of cytologic and colposcopic findings in preclinical cervical cancer. Malays J Pathol, 1991; 13(2):105-8.

Pimple SA, Amin G, Goswami S, Shastri SS, Evaluation of colposcopy vs cytology as secondary test to triage women found positive on visual inspection test. Indian J Cancer. 2010;47(3):308-13.

Stafl A, Mattingly RF. Colposcopic diagnosis of cervical neoplasia. Obstet Gynecol. 1973;41(2):168-76.