[Performance of cervical cytology with review by different observers and hybrid capture II in the diagnosis of cervical intraepithelial neoplasia grades 2 and 3].
To evaluate the performance of initial cervical cytology and that collected at the reference service with a review conducted by different observers and techniques, as well as hybrid capture II, in the diagnosis of high-grade cervical intraepithelial neoplasia (CIN), 105 women attended from August 2000 to June 2001 for preneoplastic atypia upon cervical cytology were included. A new cervical cytology and hybrid capture II for DNA-HPV were conducted in all the patients. Cervical biopsies were taken in 91 women. Performance of the investigative procedures was described by estimating the sensitivity, specificity, and positive likelihood ratio (PLR), with a 95% confidence interval (95% CI), considering histological diagnosis the gold standard.


RESULTS
initial cervical cytology showed sensitivity and specificity of 57% and 82% for diagnosis of CIN grades 2 and 3, with a PLR of 3.2 (95% CI: 1.5-6.8). Referral cervical cytology showed a sensitivity and specificity for CIN 2 and 3 of 79% and 84%, respectively, with a PLR of 5.0 (95% CI: 2.5-10.0). Sensitivity (86%), specificity (80%), and PLR (4.3) were similar when a second observer (using a routine technique) reviewed the slide. Using rapid revision by a third observer, the sensitivity was significantly lower (64%). Hybrid capture II showed a high sensitivity (100%), low specificity (43%), and low PLR (1.7, 95% CI: 1.4-2.2).
Santos
André Luís Ferreira
AL
Hospital Universitário de Taubaté, Taubaté, SP, 2020-130, Brasil.
Derchain
Sophie Françoise Mauricette
SF
Calvert
Evelyn Bartholo
EB
Martins
Marcos Roberto
MR
Dufloth
Rozany Mucha
RM
Martinez
Edson Zangiacomi
EZ
D003127:Colposcopy / Q000379:methods*; D003584:Cytological Techniques; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D015588:Observer Variation; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000473:pathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014412:Tumor Virus Infections / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000821:virology
D004279:DNA, Viral
Desempenho do exame colpocitológico com revisão por diferentes observadores e da captura híbrida II no diagnóstico da neoplasia intra-epitelial cervical graus 2 e 3.