Barut Mert Ulaş, Kale Ahmet, Kuyumcuoğlu Umur, Bozkurt Murat, Ağaçayak Elif, Özekinci Server, Gül Talip
Department of Obstetrics and Gynecology, Health Research System In Vitro Fertilization (HRS IVF) Center, Ankara, Turkey.
Department of Obstetrics and Gynecology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
Med Sci Monit. 2015 Dec 10;21:3860-7. doi: 10.12659/msm.895227.
BACKGROUND This study aimed to examine the positive and negative predictive value in the diagnosis of premalignant and malignant lesions of cervical colposcopy, the sensitivity and specificity of smear, and to evaluate the correlation with histopathology of abnormal cytology and colposcopy. MATERIAL AND METHODS The criteria for inclusion of patients with unhealthy cervix in the study were: Erosion, Chronic cervicitis, and Healed lacerations, Hypertrophied cervix, bleeding on touch, suspicious growth/ulcer/polyp on the cervix, and abnormal discharges from the cervix. Women with frank carcinoma cervix, pregnant females, patients with bleeding per vaginum at the time of examination, and those who had used vaginal medications, vaginal contraceptives or douches in the last 48 h of examination were excluded from the study. Demographic analysis was performed for 450 patients who were admitted to the clinic. Sensitivity, specificity, positive predictive value and negative predictive values of patients to identify cervical pathologies of smear and colposcopy were histopathologically calculated. The statistical software package SPSS 15.0 (SPSS Inc., Chicago, IL, USA) and Spearman's and Chi-Square tests were used for statistical analysis. RESULTS Sensitivity, specificity, PPD and NDP of smear were 0.57%, 0.76%, 0.26%, 0.92% respectively. Sensitivity, specificity, PPD and NDP of colposcopy were 0.92%, 0.67%, 0.52%, 0.96% respectively. A statistically significant correlation was found between abnormal cytology and histopathology, and abnormal colposcopy finding and histopathology. CONCLUSIONS Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions. It was concluded that Pap smear, colposcopy and histopathology should be collectively evaluated to evaluate cervical findings in low socio-economic regions.
背景 本研究旨在探讨阴道镜检查在诊断宫颈癌前病变和恶性病变中的阳性和阴性预测价值、涂片检查的敏感性和特异性，并评估异常细胞学和阴道镜检查与组织病理学的相关性。
材料与方法 本研究纳入宫颈不健康患者的标准为：宫颈糜烂、慢性宫颈炎、陈旧性裂伤、宫颈肥大、触血、宫颈可疑肿物/溃疡/息肉以及宫颈异常分泌物。排除患有宫颈癌的女性、孕妇、检查时阴道出血的患者以及在检查前48小时内使用过阴道药物、阴道避孕药或阴道灌洗的患者。对450例门诊患者进行人口统计学分析。通过组织病理学计算患者识别宫颈涂片和阴道镜检查病变的敏感性、特异性、阳性预测值和阴性预测值。使用统计软件包SPSS 15.0（美国伊利诺伊州芝加哥市SPSS公司）以及Spearman检验和卡方检验进行统计分析。
结果 涂片检查的敏感性、特异性、阳性预测值和阴性预测值分别为0.57%、0.76%、0.26%、0.92%。阴道镜检查的敏感性、特异性、阳性预测值和阴性预测值分别为0.92%、0.67%、0.52%、0.96%。发现异常细胞学与组织病理学之间以及异常阴道镜检查结果与组织病理学之间存在统计学显著相关性。
结论 临床诊断为宫颈不健康的女性应进行细胞学检查以检测任何癌前或恶性病变。得出结论，在社会经济水平较低地区，应综合评估巴氏涂片、阴道镜检查和组织病理学以评估宫颈检查结果。
