Rahman Zakia, Yadav Garima, Tripathi Urmila
Department of Obstetrics and Gynaecology, Gajra Raja Medical College, Gwalior, Madhya Pradesh 474001 India.
J Obstet Gynaecol India. 2020 Dec;70(6):497-502. doi: 10.1007/s13224-020-01344-2. Epub 2020 Jul 4.
The accuracy of colposcopy has recently been called into question particularly with regard to determining the site requiring biopsy. The technique of colposcopy is largely operator dependent, and the agreement between colposcopists is less reliable than once presumed. In an attempt to standardize colposcopy a new scoring system, the Swede score has been devised, which includes lesion size as a variable to be scored in addition to the 4 variables found in the modified Reids Colposcopic Index (RCI).
To assess the diagnostic accuracy of Swede score for pre-invasive cervical lesion.
A cross-sectional study in a tertiary care centre.
Swede score was calculated for assessment of pre-invasive cervical lesions on patients undergoing colposcopy who were suspected with pre-invasive cervical lesion. Cervical biopsy was taken if modified RCI ≥ 3 or Swede score ≥ 5. Histopathology report of the cervical biopsy was taken as gold standard.
Swede scores of 5 or more had sensitivity, specificity, positive and negative predictive values of 94.9%, 88.4%, 75.5% and 92.9% respectively.
The Swede score by just incorporating one additional variable that is size of the lesion, showed better correlation with histopathology.
最近，阴道镜检查的准确性受到质疑，尤其是在确定需要活检的部位方面。阴道镜检查技术很大程度上依赖于操作人员，阴道镜检查医师之间的一致性不如以前认为的那样可靠。为了使阴道镜检查标准化，设计了一种新的评分系统——瑞典评分，除了改良的Reid阴道镜指数（RCI）中的4个变量外，该评分系统还将病变大小作为一个要评分的变量。
评估瑞典评分对宫颈浸润前病变的诊断准确性。
在一家三级护理中心进行的横断面研究。
对接受阴道镜检查且疑似宫颈浸润前病变的患者计算瑞典评分，以评估宫颈浸润前病变。如果改良RCI≥3或瑞典评分≥5，则进行宫颈活检。将宫颈活检的组织病理学报告作为金标准。
瑞典评分5分及以上的敏感度、特异度、阳性预测值和阴性预测值分别为94.9%、88.4%、75.5%和92.9%。
瑞典评分仅通过纳入一个额外变量（即病变大小），就显示出与组织病理学有更好的相关性。
