Medicinski vjesnik, Vol. 38 No. (1-4), 2006.
Stručni rad
Cytologyand colposcopy as a screening test for preinvasive and early invasive lesions of cervix uteri
Marija Pajtler
Miodrag Milojković
Sažetak
We have included 1000 nongravid women who had cytological and colposcopical examination done independently. 207 women with abnormal cytological and/or colposcopical finding had a histological examination. Comparing cytological and colposcopical with histological findings, we could determine the value of cytology and colposcopy as methods of screening in the case of intraepithelial and early invasive lesions of cervix uteri. Sensitivity of cytology is 90%, specificity 74%, positive predictive value 92%, negative predictive value 69% and total diagnostic accuracy 92%. The proportion of false-negative findings is 10%, whereof 3.1% can be considered as a screening error and remaining 6.9% as a sampling error. The proportion of false positive findings is 1.4%; whereof 0.6% referred to interpretation errors and 0.8% should be clarified with cytological/histological follow-up. Sensitivity of colposcopy is 88%, specificity 15%, positive predictive value 78%, negative predictive value 27% and total diagnostic accuracy 78%. The share of false-negative findings is 12%. Cytology and colposcopy applied together have sensitivity 99%, specificity 98%, positive predictive value 99%, negative predictive value 75% and total diagnostic accuracy 99%. Cytology is more accurate in detection of lesions and major reasons of its unsuccessfulness are sampling errors, less often - screening errors. In comparison to cytology, colposcopy is less accurate and the reasons for its unsuccessfulness are endocervical localization of the lesion which results in false-negative findings, whereas, at the same time, some benign changes (immature squamous metaplasia) can produce colposcopic abnormality and falsepositive finding. When applied together, cytology and colposcopy can achieve diagnostic accuracy of almost 100%.
Ključne riječi
Cervix uteri; Cervical intraepithelial neoplasia (CIN); the Pap Test (The Pap smear); colposcopy
Hrčak ID:
191056
URI
Datum izdavanja:
1.12.2006.
Posjeta: 2.006 *