Diagnostic value of colposcopy and histopathology in patients with abnormal Pap smear and suspicious clinical findings referring to Sanandaj Besat Hospital in 2012-2014

Document Type : Original Article

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Sanandaj University of Medical Sciences, Sanandaj, Iran

2 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Sanandaj University of Medical Sciences, Sanandaj, Iran

3 Nurse, Faculty of Medicine, Sanandaj University of Medical Sciences, Sanandaj, Iran

4 Graduated in Medicine, Faculty of Medicine, Sanandaj University of Medical Sciences, Sanandaj, Iran.

Abstract

Introduction: Cervical cancer is one of the main causes of women's mortality in many of developing world countries and had a significant increase in recent years. Using appropriate screening methods, this disease can be diagnosed at early stages and the deaths caused by it will be reduced. This study was performed with aim to compare the results of colposcopy and histology in patients with abnormal Pap smear or suspicious clinical findings.
Methods: This cross-sectional analytic study was performed on 75 patients who had referred to Besat Hospital in Sanandaj from January 2013 to January 2016 with abnormal Pap smear and suspicious clinical findings in order to perform colposcopy and Pap smear. Colposcopic results and histological findings were extracted from the patients' files. Data were analyzed using SPSS software (version 22) and Chi-square test. The confidence intervals for diagnostic value indices were 0.05.
Results: Histopathology and colposcopy studies were conducted on 36 patients with abnormal Pap smear and 39 patients with suspicious symptoms and clinical findings. Sensitivity and specificity of colposcopy were 69.23% and 73.46%, respectively. The positive and negative predictive values of colposcopy were 58.07% and 81.82%, respectively. There was significant relationship between the results of colposcopy and histology.
Conclusion: In cases of abnormal Pap smear and suspicious clinical findings, colposcopy can be used to validate the findings.

Keywords

References

  1. Aldrich T, Becker D, García SG, Lara D. Mexican physicians' knowledge and attitudes about the human papillomavirus and cervical cancer: a national survey. Sex Transm Infect 2005; 81(2):135-41.
  2. Seth T, Kotwal A, Thakur R, Singh P, Kochupillai V. Common cancers in India: knowledge, attitudes and behaviours of urban slum dwellers in New Delhi. Public Health 2005; 119(2):87-96.
  3. Ramezani R. Iranian annual of national cancer registration report. Tehran: Tandis; 2007. P. 26-34.
  4. Novak E. Berek and Novak's gynecology. Philadelphia: Lippincott Williams & Wilkins; 2007. P. 1199-232.
  5. Raab SS. Can glandular lesions be diagnosed in pap smear cytology? Diagn Cytopathol 2000; 23(2):127-33.
  6. Percac-Lima S, Aldrich LS, Gamba GB, Bearse AM, Atlas SJ. Barriers to follow-up of an abnormal Pap smear in Latina women referred for colposcopy. J Gen Intern Med 2010; 25(11):1198-204.
  7. Syrjänen K, Naud P, Derchain S, Roteli-Martins C, Longatto-Filho A, Tatti S, et al. Comparing Pap smear cytology, aided visual inspection, screening colposcopy, cervicography and HPV testing as optional screening tools in Latin America. Study design and baseline data of the LAMS study. Anticancer Res 2005; 25(5):3469-80.
  8. Correa Mda S, Silveira DS, Siqueira FV, Facchini LA, Piccini RX, Thumé E, et al. Pap test coverage and adequacy in the South and Northeast of Brazil. Cad Saude Publica 2012; 28(12):2257-66.
  9. Chen YC, Liu HY, Li CY, Lee NY, Ko WC, Chou CY, et al. Low papanicolaou smear screening rate of women with HIV infection: a nationwide population-based study in Taiwan, 2000-2010. J Womens Health (Larchmt) 2013; 22(12):1016-22.
  10. Bobdey S, Sathwara J, Jain A, Balasubramaniam G. Burden of cervical cancer and role of screening in India. Indian J Med Paediatr Oncol 2016; 37(4):278-85.
  11. Geldenhuys L, Murray ML. Sensitivity and specificity of the Pap smear for glandular lesions of the cervix and endometrium. Acta Cytol 2007; 51(1):47-50.
  12. Tuon FF, Bittencourt MS, Panichi MA, Pinto AP. Sensibility and specificity of cytology and colposcopy exams with the histological evaluation of cervical intraepithelial lesions. Rev Assoc Med Bras 2002; 48(2):140-4.
  13. Pourjavad M. The accuracy of colposcopy and papanicolauo smear in cervical cancer screening. Med J Mashhad Univ Med Sci 2001; 44(72):73-8. (Persian).
  14. Vasconcelos CT, Pinheiro AK, Nicolau AI, Lima TM, Barbosa DF. Comparison among the efficacy of interventions for the return rate to receive the pap test report: randomized controlled clinical trial. Rev Lat Am Enfermagem 2017; 25:e2857.
  15. Miller AB, Sankaranarayanan R, Bosch FX, Sepulveda C. Can screening for cervical cancer be improved, especially in developing countries? Int J Cancer 2003; 107(3):337-40.
  16. Olaniyan OB. Validity of colposcopy in the diagnosis of early cervical neoplasia--a review. Afr J Reprod Health 2002; 6(3):59-69.
  17. Farzaneh F, Tamim M, Amiri Z, Alizadeh K. The value of Pap smear in detecting cervical neoplasia compared with histopathologic findings in patients referred to Taleghani Hospital, Tehran 2007-2009. Pajoohandeh J 2011; 16(2):92-7. (Persian).
  18. Ghaem Maghami F, Ensani F, Behtash N, Hosseini Nejad SE. Histologic findings of uterine cervix among women with cytologic diagnosis of ASCUS (Atypical Squamous Cells Of Undetermined Significance). Tehran Univ Med J 2004; 62(4):326-31. (Persian).
  19. Sellors JW, Sankaranarayanan R. Colposcopy and treatment of cervical intraepithelial neoplasia: a beginner's manual. Geneva: World Health Organization; 2003. P. 4.
  20. Dadkhah F, Alishah N. A comparative study on colposcopy directed biopsy and Pap smear tests in patients with an abnormal Pap smear. Iran J Pathol 2006; 1(1):13-6. (Persian).
  21. Tawa K, Forsythe A, Cove JK, Saltz A, Peters HW, Watring WG. A comparison of the Papanicolaou smear and the cervigram: sensitivity, specificity, and cost analysis. Obstet Gynecol 1988; 71(2):229-35.
  22. Behnamfar F, Khamechian T, Shishegar M. Diagnostic value of colposcopy for identifying precancerns lesions of cervix in patients with pbnormal Pap smea. Feyz J Kashan Univ Med Sci 2004; 8(2):20-4. (Persian).
  23. Mehrangiz Z, Torabian S. The results of colposcopy and histology in patients referred to oncology clinic Fatemieh hospital Hamedan. Iran J Obstet Gyneocol Infertil 2013; 16(78):1-6. (Persian).

Fakor F, Aghaee Nejad SM, Moosavi SM. Pathological findings of endocervical curettage in ruotine colposcopy in abnormal Pap smear. J Guilan Univ Med Sci 2013; 22(87):1-6.

The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 20, Issue 5
July 2017
Pages 1-6

Files

Share

How to cite

Statistics