Department of Obstetrics and Gynecology, Gynecologic Oncology Surgery, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
Department of Obstetrics and Gynecology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
Medicine (Baltimore). 2023 Dec 15;102(50):e36341. doi: 10.1097/MD.0000000000036341.
Although preventable; cervical cancer remains a significant cause of morbidity and mortality worldwide, especially in developing countries; thus, early diagnosis and treatment are essential to prevent its development into invasive cancer. Based on the screening results, diagnostic colposcopy was performed to evaluate women with abnormal Papinocalaou test results, high-risk human papillomavirus DNA positivity, or suspected cervical cancer. Therefore, this study aimed to determine the optimal acetic acid concentration (5% or 8%) for detecting cervical precancerous/cancerous lesions during colposcopy evaluation. This study included 607 patients admitted to our obstetrics and gynecology clinic. The medical records of the patients were obtained from the colposcopy registry in the hospital information system and retrospectively analyzed. The cases were divided into 2 groups according to the acetic acid concentrations (5% and 8%) used during colposcopy and examined. The duration of acetic acid application was 2 to 4 minutes. The probability of developing ≥ CIN2 was low in patients with negative for intraepithelial lesion or malignancy smear results in both groups, but increased in the high-grade squamous intraepithelial lesions/atypical squamous cells group with the 8% acetic acid concentration (P < .0001; P = .012). The probabilities of pathological detection of ≥ CIN2 in the 5% and 8% acetic acid groups were 17.3% and 46.6%, respectively (P < .0001). The enhancement of the efficiency of colposcopy should focus on improving the detectability of precancerous lesions. Given that this study compared the effectiveness of acetic acid concentration in colposcopy diagnostics, it can be considered a leading study in this field.
虽然宫颈癌是可以预防的,但它仍然是全球发病率和死亡率的重要原因,尤其是在发展中国家;因此,早期诊断和治疗对于预防其发展为浸润性癌症至关重要。根据筛查结果,对巴氏涂片检查结果异常、高危型人乳头瘤病毒 DNA 阳性或疑似宫颈癌的妇女进行诊断性阴道镜检查。因此,本研究旨在确定阴道镜检查评估中用于检测宫颈癌前病变/癌前病变的最佳醋酸浓度(5%或 8%)。本研究纳入了 607 例就诊于我院妇产科的患者。从医院信息系统的阴道镜检查登记处获取患者的病历并进行回顾性分析。根据阴道镜检查中使用的醋酸浓度(5%和 8%)将病例分为两组进行检查。醋酸应用时间为 2 至 4 分钟。两组中上皮内病变或恶性涂片结果阴性的患者发生≥CIN2 的概率较低,但高级别鳞状上皮内病变/非典型鳞状细胞组中 8%醋酸浓度的患者发生≥CIN2 的概率增加(P<0.0001;P=0.012)。5%和 8%醋酸组的≥CIN2 病理检出率分别为 17.3%和 46.6%(P<0.0001)。阴道镜检查效率的提高应侧重于提高癌前病变的检出率。鉴于本研究比较了醋酸浓度在阴道镜诊断中的有效性,因此可以认为它是该领域的一项领先研究。