Ciavattini Andrea, Serri Matteo, Di Giuseppe Jacopo, Liverani Carlo A, Fallani Maria G, Tsiroglou Dimitrios, Papiccio Maria, Delli Carpini Giovanni, Pieralli Annalisa, Clemente Nicolò, Sopracordevole Francesco
Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Via Corridoni 11, 6010, Ancona, Italy.
Woman's Health Sciences Department, Gynecologic Section, Polytechnic University of Marche, Via Corridoni 11, 6010, Ancona, Italy.
Eur J Obstet Gynecol Reprod Biol. 2018 Oct;229:76-81. doi: 10.1016/j.ejogrb.2018.07.029. Epub 2018 Jul 27.
To investigate the reliability of colposcopy during pregnancy and to evaluate the concordance between colposcopic patterns and histopathological findings in these women.
Multicenter observational study of women diagnosed with an abnormal cervical cytology, who subsequently underwent a colposcopic evaluation with cervical biopsy during pregnancy. The "colpo-histopathological concordance‿ was evaluated. The "colposcopic overestimation and underestimation‿ were evaluated as well.
69 women, fulfilling the study inclusion/exclusion criteria, constituted the study cohort. Among them, on colposcopic examination, 14 women (20.3%) showed "grade I abnormal colposcopic findings‿, 52 (75.4%) showed "grade II abnormal colposcopic findings‿ and the remaining 3 women (4.3%) had a "suspicious for invasion‿ colposcopy. The histopathological diagnosis showed 2 negative biopsies, 12 (17.4%) cases of CIN1, 50 (72.5%) cases of CIN2 and 5 (7.2%) cases of invasive cervical cancer. We found a colposcopic overestimation in 10 cases (14.5%), underestimation in 12 cases (17.4%), and a concordance in 47 cases (68.1%). A better reliability of colposcopy in women in the firsts two trimesters and in particular in women ≤20 weeks pregnant was found (Cohen's weighted kappa: 0.65).
When performed by gynecologists with expertise, colposcopy is a reliable diagnostic tool, even during pregnancy. Whenever possible, a colposcopic evaluation during the first half of pregnancy is preferable.
探讨孕期阴道镜检查的可靠性，并评估这些女性阴道镜检查结果与组织病理学检查结果的一致性。
对诊断为宫颈细胞学异常的女性进行多中心观察性研究，这些女性随后在孕期接受了阴道镜检查及宫颈活检。评估“阴道镜-组织病理学一致性”，同时评估“阴道镜高估和低估情况”。
69名符合研究纳入/排除标准的女性组成了研究队列。其中，阴道镜检查时，14名女性（20.3%）表现为“阴道镜I级异常发现”，52名（75.4%）表现为“阴道镜II级异常发现”，其余3名女性（4.3%）阴道镜检查“怀疑浸润”。组织病理学诊断显示2例活检阴性，12例（17.4%）为CIN1，50例（72.5%）为CIN2，5例（7.2%）为浸润性宫颈癌。我们发现10例（14.5%）阴道镜高估，12例（17.4%）低估，47例（68.1%）一致。发现前两孕期女性尤其是孕周≤20周的女性阴道镜检查可靠性更高（Cohen加权kappa值：0.65）。
由专业妇科医生进行操作时，阴道镜检查是一种可靠的诊断工具，即使在孕期也是如此。只要有可能，孕期前半段进行阴道镜评估更佳。
