Accuracy of Visual Inspection with Acetic acid in Detecting High-Grade Cervical Intraepithelial Neoplasia in Pre- and Post-Menopausal Thai Women with Minor Cervical Cytological Abnormalities
| Autor: | Komsun Suwannarurk, Yenrudee Poomtavorn |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Epidemiology Uterine Cervical Neoplasms Papanicolaou stain Cervical intraepithelial neoplasia Young Adult Cytology Biopsy Atypical Squamous Cells of the Cervix medicine Humans Neoplasms Squamous Cell Papillomaviridae Acetic Acid Aged Neoplasm Staging Vaginal Smears Gynecology Colposcopy medicine.diagnostic_test business.industry Papillomavirus Infections Public Health Environmental and Occupational Health Middle Aged Prognosis Thailand Uterine Cervical Dysplasia medicine.disease Squamous intraepithelial lesion Oncology DNA Viral High Grade Cervical Intraepithelial Neoplasia Female Histopathology Menopause Neoplasm Grading business Follow-Up Studies Papanicolaou Test |
| Zdroj: | Asian Pacific Journal of Cancer Prevention. 16:2327-2331 |
| ISSN: | 1513-7368 |
| DOI: | 10.7314/apjcp.2015.16.6.2327 |
| Popis: | Purpose To determine the accuracy of visual inspection with acetic acid (VIA) in detecting high-grade cervical intraepithelial neoplasia (CIN) in pre- and post-menopausal women with atypical squamous cells of undetermined significance (ASC-US) and low grade squamous intraepithelial lesion (LSIL) Papanicolaou (Pap) smears. Materials and methods Two hundred women (150 pre-menopausal and 50 post-menopausal) with ASC- US and LSIL cytology who attended the colposcopy clinic, Thammasat University Hospital, between March 2013 and August 2014 were included. All women underwent VIA testing and colposcopy by gynecologic oncologists. Diagnostic values of VIA testing including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting high-grade CIN were determined using the histopathology obtained from colposcopic-directed biopsy as a gold standard. Results VIA testing was positive in 54/150 (36%) pre-menopausal women and 5/50 (10%) post-menopausal women. Out of 54 pre-menopausal women with positive VIA testing, 15 (27.8%) had high-grade CIN and 39 (72.2%) had either CIN 1 or insignificant pathology. Ten (10.4%), 43 (44.8%) and 43 (44.8%) out of the remaining 96 pre-menopausal women with negative VIA testing had high- grade CIN, CIN 1 and insignificant pathology, respectively. Out of 5 post-menopausal women with positive VIA testing, there were 4 (80%) women with high-grade CIN, and 1 (20%) women with insignificant pathology. Out of 45 VIA-negative post-menopausal women, 42 (93.3%) women had CIN 1 and insignificant pathology, and 3 (6.7%) had high-grade CIN. Sensitivity, specificity, PPV and NPV of the VIA testing were 59.4%, 76.2%, 32.2% and 90.8%, respectively (60%, 68.8%, 27.8% and 89.6% in pre-menopausal women and 57.1%, 97.7%, 80% and 93.3% in post-menopausal women). Conclusions VIA testing may be used as a screening tool for detecting high-grade CIN in women with minor cervical cytological abnormalities in a low-resource setting in order to lower the rate of colposcopy referral. |
| Databáze: | OpenAIRE |
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