Reid R, Stanhope C R, Herschman B R, Crum C P, Agronow S J
Am J Obstet Gynecol. 1984 Aug 15;149(8):815-23. doi: 10.1016/0002-9378(84)90597-0.
Five colposcopic signs (thickness, color, contour, vascular atypia, and iodine staining) were graded into three objective categories representing (1) subclinical papillomaviral infection, (2) lower-grade dysplasia, and (3) grade 3 cervical intraepithelial neoplasia. Seventy-two colposcopically different biopsy specimens (25 of subclinical papillomaviral infection and 18 of grade 1, 18 of grade 2, and 11 of grade 3 cervical intraepithelial neoplasia) were collected from 52 women and interpreted by validated, quantitative histologic analysis. Attempts to grade lesions by the prominence of the acetowhitening reaction or the mere presence of aberrant surface capillaries were unsuccessful. In contrast, each of five new colposcopic criteria were significantly correlated with histologic severity. Differences in color, vascular atypia, and iodine staining were more predictive than those of thickness and contour. Combined into a weighted index, these colposcopic features were 96% correct in forecasting approximate histologic findings. Because this method relies upon critical analysis rather than pattern recall, the use of this colposcopic index greatly simplifies the learning of colposcopy.
五种阴道镜检查体征（厚度、颜色、轮廓、血管异型性和碘染色）被分为三个客观类别，分别代表（1）亚临床乳头瘤病毒感染，（2）低度发育异常，以及（3）3级宫颈上皮内瘤变。从52名女性中收集了72份阴道镜检查结果不同的活检标本（25份亚临床乳头瘤病毒感染标本，18份1级、18份2级和11份3级宫颈上皮内瘤变标本），并通过经过验证的定量组织学分析进行解读。试图通过醋酸白反应的突出程度或仅仅根据异常表面毛细血管的存在来对病变进行分级均未成功。相比之下，五种新的阴道镜检查标准中的每一项都与组织学严重程度显著相关。颜色、血管异型性和碘染色方面的差异比厚度和轮廓方面的差异更具预测性。将这些阴道镜检查特征合并为一个加权指数后，在预测大致的组织学结果方面，其准确率达96%。由于该方法依赖于批判性分析而非模式记忆，因此使用这种阴道镜检查指数极大地简化了阴道镜检查的学习过程。
