Mousavi Azam Sadat, Fakour Fereshteh, Gilani Mitra Modares, Behtash Nadereh, Ghaemmaghami Fatemeh, Karimi Zarchi Mojgan
Department of Gynecology Oncology, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Low Genit Tract Dis. 2007 Jul;11(3):147-50. doi: 10.1097/LGT.0b013e318030bc3e.
To determine the strength of correlation between colposcopic impression using Reid index and biopsy histology.
In a colposcopy referral clinic in Tehran University, Iran. Colposcopy was carried out using Reid colposcopic index (RCI) scoring system and directed biopsy on 344 women between March 2004 and October 2005 by fellows supervised by a board-certified gynecologic oncologist. Results were retrospectively compared with a previous study carried out on 353 women by the same physicians. In this previous study, the colposcopy findings did not use RCI index; the significance of association between these 2 studies was assessed by chi(2) and kappa statistics.
The association between colposcopic impression and biopsy histology was highly significant (p < .001), both in RCI colposcopy group and general colposcopy group. However, the strength of the correlation between colposcopy impression and biopsy histology in RCI colposcopy group was more than the general colposcopy group (0.74 vs 0.45). The positive predictive value of any colposcopic abnormality for any histologic abnormalities in the RCI group was 92%. The negative predictive value of a benign colposcopic impression was 70.5%. The sensitivity was 74%, and the specificity was 90.7%.
The good correlation between colposcopic impression and histological diagnosis by using Reid index in colposcopy would produce higher agreement and strength of the correlation. Therefore, the Reid index can be used as a reproducible technique which is easy to learn in colposcopic clinic.
确定使用里德指数的阴道镜印象与活检组织学之间的关联强度。
在伊朗德黑兰大学的一家阴道镜转诊诊所。于2004年3月至2005年10月期间,由一名获得董事会认证的妇科肿瘤学家指导的研究员,对344名女性进行了使用里德阴道镜指数(RCI)评分系统的阴道镜检查及定向活检。结果与同一组医生之前对353名女性进行的一项研究进行了回顾性比较。在之前的这项研究中,阴道镜检查结果未使用RCI指数;通过卡方检验和kappa统计评估这两项研究之间关联的显著性。
在RCI阴道镜检查组和普通阴道镜检查组中,阴道镜印象与活检组织学之间的关联均具有高度显著性(p <.001)。然而,RCI阴道镜检查组中阴道镜印象与活检组织学之间的关联强度高于普通阴道镜检查组(0.74对0.45)。RCI组中任何阴道镜异常对任何组织学异常的阳性预测值为92%。阴道镜印象为良性的阴性预测值为70.5%。敏感性为74%,特异性为90.7%。
在阴道镜检查中使用里德指数时,阴道镜印象与组织学诊断之间的良好相关性会产生更高的一致性和关联强度。因此,里德指数可作为一种易于在阴道镜诊所学习的可重复技术使用。