Colposcopic characteristics of high-risk human papillomavirus-related cervical lesions.
OBJECTIVE
Because high-risk human papillomavirus (hrHPV) is the necessary factor in the development of high-grade cervical lesions, knowing the colposcopic differences between hrHPV-positive and hrHPV-negative lesions could be of value. We have evaluated whether there are colposcopic differences between lesions testing hrHPV-positive or hrHPV-negative.


METHODS
This study was conducted as a retrospective case-control study. We designed a scoring system for colposcopic criteria that might be of relevance to distinguish hrHPV-positive from hrHPV-negative lesions. Colposcopic images were analyzed from patients at the VU University Medical Center Amsterdam, the Netherlands, in whom a GP5+/6+ polymerase chain reaction hrHPV test had been performed within a month of the colposcopic examination (n = 507).


RESULTS
Visibility of the transformation zone (corrected for age), a (very) coarse and irregular punctation pattern, and a large lesion (>25% of the visible cervix) were more often associated with a positive hrHPV test status (p =.001, odds ratio [OR] = 2.29, 95% CI = 1.41-3.73; p =.036, OR 2.37, 95% CI = 1.08-5.19; and p =.044, OR = 1.78, 95% CI = 1.08-2.94, respectively). After correction for histologic diagnosis, the difference between hrHPV-positive and hrHPV-negative lesions for visibility of the transformation zone and lesion size remained statistically significant (OR = 2.44, 95% CI = 1.35-4.41 and OR = 1.92, 95% CI = 1.04-3.54, respectively).


CONCLUSIONS
This study indicates that visibility of the transformation zone, (very) coarse punctation pattern, and larger lesion size were the main colposcopic features associated with a hrHPV-positive test status.
Louwers
Jacqueline A
JA
Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, the Netherlands. ja.louwers@vumc.nl
Kocken
Mariëlle
M
van der Bijl
Joyce C
JC
Berkhof
Johannes
J
Snijders
Peter J F
PJ
Meijer
Chris J L M
CJ
Verheijen
René H M
RH
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003127:Colposcopy; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008875:Middle Aged; D009426:Netherlands; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology*; D016133:Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D002577:Uterine Cervical Diseases / Q000175:diagnosis* / Q000473:pathology*; D055815:Young Adult
D004279:DNA, Viral