Department of Obstetrics and Gynecology, Kyungpook National University Hospital, Graduate School of Medicine, Daegu, South Korea.
Int J Clin Oncol. 2010 Feb;15(1):65-9. doi: 10.1007/s10147-009-0012-6. Epub 2010 Jan 20.
Colposcopic grading provides an objective and meaningful guide to histologic severity and neoplastic progression of squamous intraepithelial lesions of the cervix. The objective of this study was to develop a more efficient and convenient method to overcome procedural complexities involved with the traditional Reid index in prediction of high-grade squamous intraepithelial lesion (HSIL).
The Reid index uses four colposcopic signs (margin, color, vessel, and iodine staining). The proposed modified Reid index system specifically incorporates the location of the lesion within the transformation zone in place of iodine staining. Three hundred women with suspected or abnormal cytologies or abnormal cervicographic findings were evaluated by colposcopy, directed biopsy, and HPV testing by the Hybrid Capture II method, which detects high-risk HPV DNA types.
The sensitivity of high-risk HPV testing for detecting HSIL was 94.4%, the specificity was 65.0%, the positive predictive value was 75.5%, and the negative predictive value was 91.0%. The results of the colposcopic impression using the modified Reid index were superior to HPV testing. The sensitivity, specificity, positive predictive value, and negative predictive value of the colposcopic impression for detecting HSIL were 91.3, 92.9, 93.6, and 90.3% respectively.
These results strongly indicate that the modified Reid index can accurately predict the histologic grade of squamous intraepithelial lesions of the cervix and can be applied easily and objectively in clinical practice without affecting the diagnostic accuracy of the traditional Reid index.
阴道镜分级为宫颈鳞状上皮内病变的组织学严重程度和肿瘤进展提供了客观而有意义的指导。本研究旨在开发一种更有效和方便的方法来克服传统 Reid 指数在预测高级别鳞状上皮内病变（HSIL）中涉及的程序复杂性。
Reid 指数使用四个阴道镜征象（边缘、颜色、血管和碘染色）。所提出的改良 Reid 指数系统专门用病变在转化区的位置代替碘染色。对 300 名疑似或异常细胞学或异常宫颈图发现的女性进行阴道镜检查、定向活检和 HPV 检测，采用杂交捕获 II 法检测高危型 HPV DNA 型。
高危型 HPV 检测对 HSIL 的检测敏感性为 94.4%，特异性为 65.0%，阳性预测值为 75.5%，阴性预测值为 91.0%。改良 Reid 指数的阴道镜印象结果优于 HPV 检测。阴道镜印象对 HSIL 的检测敏感性、特异性、阳性预测值和阴性预测值分别为 91.3%、92.9%、93.6%和 90.3%。
这些结果强烈表明，改良 Reid 指数可以准确预测宫颈鳞状上皮内病变的组织学分级，并且可以在不影响传统 Reid 指数诊断准确性的情况下，在临床实践中方便且客观地应用。
