Combination of cytology and colposcopy in diagnosis of cervical intraepithelial neoplasia.

A 12-month study of 276 patients with erythroplakia investigated the use of colposcopy in combination with cytology to increase findings of cervical intraepithelial neoplasia (CIN). Colposcopic, cytologic, and histologic findings were compared, and and patients were evaluated in relation to age and parity. In 100 detected cases (36.2%), CIN was diagnosed in 44.7% of patients aged 30-33 years and in 46.9% of patients with parity 3; it was also found in patients with parity 0. Abnormal colposcopic findings were observed with abnormal cytology in 32 of 39 cases, with inflammatory cytology in 107 of 161 cases, and with normal cytology in 41 of 76 cases. In these respective groups, CIN I (very mild and mild dysplasia) was diagnosed in 7, 36, and 15 cases; CIN II (moderate dysplasia), in 10, 13, and 4 cases; CIN III (severe dysplasia and carcinoma in situ) in 5, 3, and 1 cases. Eighty-three of 85 CIN cases (97.6%) treated by cryosurgery had good results with follow-up period of 6-12 months. It was concluded that colposcopy was effective as an instrument for collection of specimens with observed abnormalities, and that normal and inflammatory cytology alone were no guarantee of a cervix free of dysplasia. Colposcopy in combination with cytology permitted increased ability to detect CIN.