title: Correlations between colposcopy and histologic results from colposcopically directed biopsy in cervical precancerous lesions.
abstract: BACKGROUND
  Cervical cancer develops from well-defined precursor lesions in a varied period of time. Detected in early or pre-invasive stages, cervical cancer is preventable and curable, so detection of precancerous lesions is very important. Colposcopy with directed biopsy is used in the evaluation and management of patients with cervical lesions, and described as the 'gold standard' for the diagnosis of cervical precancer.
  
  
  OBJECTIVE
  The aim of this study is to assess the accuracy of colposcopic examination and cervical punch biopsy, to determine the correlation between these two methods.
  
  
  METHODS
  We examined 245 patients who present malignant findings at colposcopy and biopsy. Colposcopic findings in our study group: 28 (11.4%) cases were CIN I, 50 (20.4%) cases were CIN II, 150 (61.2%) cases were CIN III, 13 (5.3%) cases were micro-invasive carcinoma and four (1.6%) cases were CIS. Histological results in the 245 examined cases were: four (1.6%) cases normal, 26 (10.6%) cases CIN I, 55 (22.4%) cases CIN II, 138 (56.3%) cases CIN III, 15 (6.1%) cases micro-invasive carcinoma and seven (2.8%) cases of CIS.
  
  
  RESULTS
  The correlation was 78.5% in the CIN I category, 84% in the CIN II category, 88.6% (133 out of 150 patients) in the CIN III category, 46.1% for micro-invasive carcinoma and 50% for CIS. The colposcopy method incurred fewer false negatives (four patients), giving a general accuracy rate of 98.3%. Sensitivity of colposcopic examination was 83.6%.
  
  
  CONCLUSIONS
  This study demonstrated high accuracy and correlation between colposcopy and histology, comparable with results from similar studies in the literature. Sensitivity is lower, probably because biopsies were done in all cases, during diagnostic work-up. We also demonstrated the usefulness of these two diagnostic procedures as screening tests in preclinical cervical cancer. In our study, there were cases of under or over diagnose; the benefit of colposcopy and directed biopsy is to avoid over treatment of low-grade lesion, and under treatment of high-grade lesion.
authors.affiliation: Department of Occupational Medicine, University of Medicine and Pharmacy of Craiova, 1 Tabaci Street, Craiova, Romania. ssm11ssm@yahoo.com
authors.forename: Ancuţa
authors.initials: A
authors.lastname: Boicea
authors.forename: Anca
authors.initials: A
authors.lastname: Pătraşcu
authors.forename: V
authors.initials: V
authors.lastname: Surlin
authors.forename: D
authors.initials: D
authors.lastname: Iliescu
authors.forename: M
authors.initials: M
authors.lastname: Schenker
authors.forename: Luminiţa
authors.initials: L
authors.lastname: Chiuţu
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology