阴道镜检查联合动态光谱成像在检测和随访高级别宫颈病变中的价值。

Value of colposcopy with dynamic spectral imaging in the detection and evolution of high-grade cervical lesions.

机构信息

Instituto de Salud de la Mujer, Hospital Clínico San Carlos, IdISSC., Universidad Complutense, Madrid, Spain.

Servicio de Obstetricia y Ginecología, Hospital Universitario Sanitas La Zarzuela, Universidad Francisco de Victoria, Madrid, Spain.

出版信息

Expert Rev Med Devices. 2022 Jun;19(6):525-532. doi: 10.1080/17434440.2022.2104638. Epub 2022 Jul 26.

DOI:10.1080/17434440.2022.2104638

PMID:35858486

Abstract

OBJECTIVE

To analyze the performance of colposcopy assisted with dynamic spectral imaging (CC-DSI) compared to conventional colposcopy (CC) in diagnosing cervical intraepithelial neoplasia 2+ (CIN2+).

METHODS

In total, 973 consecutive women were referred for colposcopy between 2012 and 2016 and were examined simultaneously by CC and CC-DSI; 877 were eligible. Comparisons between CC and CC-DSI were performed against the histological diagnosis performed by either punch biopsy or loop electrosurgical excision procedure (LEEP).

RESULTS

In final histology, 494 women had no CIN, 250 had CIN1 and 133 had CIN2+. The sensitivity to identify women with CIN2+ was significantly higher for CC-DSI compared to CC for the entire group and in the subgroup of 675 women referred with ASCUS or LSIL. In women with HPV16/18 infections, the sensitivity of CC increased with the addition of DSI from 53% to 79% ( < 0.001). Using a multivariant Cox regression model, CC-DSI was an independent factor for progression of the cervical lesions (HR: 2.29, 95% CI 1.07-4.90). Other predictive factors were the number of sexual partners (HR: 1.05, 95% CI: 1.01-1.09) and anal intercourse (HR: 2.45, 95% CI 1.23-5.02).

CONCLUSION

CC-DSI improves the ability to detect cervical lesions compared to CC and could help predict their potential to progress.

摘要

目的

分析阴道镜辅助动态光谱成像（CC-DSI）与传统阴道镜（CC）在诊断宫颈上皮内瘤变 2+（CIN2+）方面的性能。

方法

2012 年至 2016 年期间，共有 973 名连续女性被转诊进行阴道镜检查，同时接受 CC 和 CC-DSI 检查；877 名符合条件。CC 和 CC-DSI 之间的比较是针对通过活检或环形电切术（LEEP）进行的组织学诊断进行的。

结果

在最终的组织学中，494 名女性没有 CIN，250 名女性有 CIN1，133 名女性有 CIN2+。CC-DSI 识别患有 CIN2+的女性的敏感性明显高于 CC，对于整个组和在转诊为 ASCUS 或 LSIL 的 675 名女性亚组中均如此。在 HPV16/18 感染的女性中，CC 的敏感性随着 DSI 的加入从 53%增加到 79%（<0.001）。使用多变量 Cox 回归模型，CC-DSI 是宫颈病变进展的独立因素（HR：2.29，95%CI 1.07-4.90）。其他预测因素是性伴侣数量（HR：1.05，95%CI：1.01-1.09）和肛交（HR：2.45，95%CI 1.23-5.02）。