Do Human Papilloma Virus and Cytological Testing Results Before Colposcopy Alter the Pathological Grading of Colposcopy Acetic Acid Visual Examination?: A Retrospective Study

Overview

Journal Int J Womens Health

Publisher Dove Medical Press

Date 2025 Feb 4

PMID 39902401

Authors

Songkun Gao

Boyang Qian

Tong Wang

Jiandong Wang

Affiliations

Soon will be listed here.

Abstract

Objective: To understand whether human papillomavirus (HPV) and cytological testing (TCT [ie, "thinprep" cytological testing]) results can provide more information beyond visual information for vaginal colposcopy examinations to upgrade or downgrade the visual diagnosis of vaginal colposcopy.

Patients And Methods: Data from 519 patients, who underwent vaginal colposcopy at the Beijing Obstetrics and Gynecology Hospital (Beijing, China) between January and June 2020, were included. Preoperative HPV and TCT results were statistically analyzed, and were divided into 3 groups according to postoperative cervical tissue pathological diagnosis: negative; low-grade squamous intraepithelial (LSIL); and high-grade squamous intraepithelial lesion (HSIL). Positive and negative predictive values for cervical inflammation, LSIL, and HSIL in patients diagnosed using vaginal colposcopy, based on cervical pathological grouping, and differences in HPV and TCT results among patients who underwent vaginal colposcopy, were analyzed.

Results: The age of patients diagnosed with cervicitis, LSIL, and HSIL using colposcopy gradually decreased, and the proportion of HPV16/18 infection in the HSIL group was significantly higher than the other 2 groups. There were significant differences in TCT results among the groups. According to pathological results from cervical tissue specimens, among all groups diagnosed using colposcopy, the age of the HSIL group was significantly younger than that of the other groups, and the proportion of patients with a TCT greater than LSIL was significantly higher than that of the other groups.

Conclusion: HPV did not provide additional information for vaginal colposcopy. Young(er) patients and those with a TCT greater than LSIL may consider upgrading the vaginal colposcopy diagnosis based on imaging information.

References

Dorji N, Tshering S, Choden S, Chhetri M, Bhujel D, Wangden T . Evaluation of the diagnostic performance of colposcopy in the diagnosis of histologic cervical intraepithelial neoplasia 2+ (CIN2+). BMC Cancer. 2022; 22(1):930. PMC: 9422165. DOI: 10.1186/s12885-022-10030-7. View

Kushwah S, Kushwah B . Correlation of Two Colposcopic Indices for Predicting Premalignant Lesions of Cervix. J Midlife Health. 2017; 8(3):118-123. PMC: 5625575. DOI: 10.4103/jmh.JMH_22_17. View

Zhang B, Hong S, Zhang G, Rong F . Clinical application of the 2011 IFCPC colposcope terminology. BMC Womens Health. 2021; 21(1):257. PMC: 8223298. DOI: 10.1186/s12905-021-01395-1. View

Benites-Zapata V, Hernandez-Bustamante E, Acuna-Chavez L, Escudero-Gaytan C, Ulloque-Badaracco J, Alarcon-Braga E . Colposcopy in the Primary Health Care: A Scoping Review. J Prim Care Community Health. 2023; 14:21501319231198942. PMC: 10517605. DOI: 10.1177/21501319231198942. View

Alfonzo E, Holmberg E, Milsom I, Strander B . Colposcopic assessment by Swedescore, evaluation of effectiveness in the Swedish screening programme: a cross-sectional study. BJOG. 2021; 129(8):1261-1267. DOI: 10.1111/1471-0528.17054. View

Reid R, Scalzi P . Genital warts and cervical cancer. VII. An improved colposcopic index for differentiating benign papillomaviral infections from high-grade cervical intraepithelial neoplasia. Am J Obstet Gynecol. 1985; 153(6):611-8. DOI: 10.1016/s0002-9378(85)80244-1. View

Baena A, Mesher D, Salgado Y, Martinez S, Villalba G, Amarilla M . Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study. Int J Cancer. 2022; 152(8):1581-1592. PMC: 10107773. DOI: 10.1002/ijc.34384. View

Agorastos T, Chatzistamatiou K, Moysiadis T, Kaufmann A, Skenderi A, Lekka I . Human papillomavirus E7 protein detection as a method of triage to colposcopy of HPV positive women, in comparison to genotyping and cytology. Final results of the PIPAVIR study. Int J Cancer. 2017; 141(3):519-530. DOI: 10.1002/ijc.30761. View

Strander B, Ellstrom-Andersson A, Franzen S, Milsom I, Radberg T . The performance of a new scoring system for colposcopy in detecting high-grade dysplasia in the uterine cervix. Acta Obstet Gynecol Scand. 2005; 84(10):1013-7. DOI: 10.1111/j.0001-6349.2005.00895.x. View

10.

Stoler M, Parvu V, Yanson K, Andrews J, Vaughan L . Risk stratification of HPV-positive results using extended genotyping and cytology: Data from the baseline phase of the Onclarity trial. Gynecol Oncol. 2023; 174:68-75. DOI: 10.1016/j.ygyno.2023.04.022. View

11.

Tsampazis N, Vavoulidis E, Siarkou C, Siarkou G, Pratilas G, Symeonidou M . Diagnostic comparison of electrical impedance spectroscopy with colposcopy and HPV mRNA-testing in the prediction of CIN2+ women in Greece. J Obstet Gynaecol Res. 2023; 49(4):1222-1229. DOI: 10.1111/jog.15557. View

12.

Hayumbu V, Hangoma J, Hamooya B, Malumani M, Masenga S . Cervical cancer and precancerous cervical lesions detected using visual inspection with acetic acid at Livingstone Teaching Hospital. Pan Afr Med J. 2022; 40:235. PMC: 8817194. DOI: 10.11604/pamj.2021.40.235.32300. View

13.

Liu Y, Liao J, Yi X, Pan Z, Pan J, Sun C . Diagnostic value of colposcopy in patients with cytology-negative and HR-HPV-positive cervical lesions. Arch Gynecol Obstet. 2022; 306(4):1161-1169. DOI: 10.1007/s00404-022-06415-5. View

14.

Akhter S, Bari A, Hayat Z . Variability study between Pap smear, Colposcopy and Cervical Histopathology findings. J Pak Med Assoc. 2015; 65(12):1295-9. View

15.

Dai W, Wang T, Chen L, Qiu Z, Chen P, Chen D . Immediate risk of cervical intraepithelial neoplasia and diagnostic value of colposcopy among cytology-negative women with oncogenic HPV: a retrospective study. BMC Womens Health. 2024; 24(1):419. PMC: 11267838. DOI: 10.1186/s12905-024-03258-x. View

16.

Wang S, Dang L, Liu S, Rezhake R, Yan H, Duan X . Cervical Cancer Screening via Visual Inspection With Acetic Acid and Lugol Iodine for Triage of HPV-Positive Women. JAMA Netw Open. 2024; 7(3):e244090. PMC: 10980959. DOI: 10.1001/jamanetworkopen.2024.4090. View

17.

Ferris D, Condorhuaman W, Waller J, Allmond L, Goebel A . Polarized Light Colposcopy Compared With Standard Colposcopy. J Low Genit Tract Dis. 2015; 19(3):234-8. PMC: 4482770. DOI: 10.1097/LGT.0000000000000111. View

18.

McGee A, Alibegashvili T, Elfgren K, Frey B, Grigore M, Heinonen A . European consensus statement on expert colposcopy. Eur J Obstet Gynecol Reprod Biol. 2023; 290:27-37. DOI: 10.1016/j.ejogrb.2023.08.369. View

19.

Ardahan M, Temel A . Visual inspection with acetic acid in cervical cancer screening. Cancer Nurs. 2011; 34(2):158-63. DOI: 10.1097/NCC.0b013e3181efe69f. View

20.

Massad L, Jeronimo J, Katki H, Schiffman M . The accuracy of colposcopic grading for detection of high-grade cervical intraepithelial neoplasia. J Low Genit Tract Dis. 2009; 13(3):137-44. PMC: 2921444. DOI: 10.1097/LGT.0b013e31819308d4. View