title: Colposcopy, cytology and histology in the diagnosis of squamous intraepithelial lesions of the cervix.
abstract: OBJECTIVE
  To compare colposcopic findings to cytologic and histological diagnoses in women with colposcopic reports of ANTZ and/or HPV infection.
  
  
  METHODS
  Among 791 hospitalized women referred for colposcopic examination, colposcopy showed ANTZ grade 0-2 and/or HPV infection in 271 patients (34.26%). Only 153 were fully investigated by colposcopy, cytology (under colposcopic observation) and histology (target punch biopsy: 109 patients; surgical specimens of hysterectomy: 42 patients; conization: 2 patients). Cytological and histological diagnoses were reported according to the Bethesda System.
  
  
  RESULTS
  132/153 Pap smears were estimable for sampling adequacy; 44/63 resulted as normal and were histologically positive for LSIL [1]. Five LSIL-positive Pap tests were negative on histology (false negative and false positive rate of 33.33% and 3.78%). The pap test was diagnostic for intraepithelial neoplasia in 34/65 cases (53.3%) and for invasive cancer in 6/11 cases (54.5%). In 67/132 cases (50.8%) adequate-for-sampling Pap smears could not predict the exact diagnosis. On the other hand, 108/141 patients with colposcopic evidence of ANTZ/cancer showed histological SIL or invasive neoplasm (76.59%): ANTZ 1 was associated to LSIL and HSIL in 74.1% and 2.4%; ANTZ 2 to LSIL, HSIL and invasive cancer in 41%, 30.76% and 10.3%. Colposcopic suspicion of invasive cancer in 8 patients was histologically demonstrated in 7 (87.5%); colposcopic diagnosis of HPV infection was confirmed in 10/12 (83.4%).
  
  
  CONCLUSIONS
  A better correspondance was shown between colposcopy and histology than between cytology and histology in the diagnosis of SIL. We suggest a routine colposcopy investigation for all patients admitted to a gynecological clinic and we believe it is very important to take Pap smears under colposcopic observation if colposcopy and cervical smears are performed in the same sitting.
authors.affiliation: Obstetric and Gynecology Dept., University of L'Aquila, S. Salvatore Hospital, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Carta
authors.forename: L
authors.initials: L
authors.lastname: Di Stefano
authors.forename: A
authors.initials: A
authors.lastname: Catellani Perelli
authors.forename: G
authors.initials: G
authors.lastname: Toro
authors.forename: M
authors.initials: M
authors.lastname: Moscarini
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000473:pathology; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000473:pathology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology