Evaluation of the accuracy of colposcopy in detecting high-grade squamous intraepithelial lesion and cervical cancer

Ruan, Yetian; Liu, Min; Guo, Junhan; Zhao, Junwei; Niu, Su-mei; Li, Fang

doi:10.1007/s00404-020-05740-x

Cited by 28 publications

(18 citation statements)

References 30 publications

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“…HPV genotyping was detected in liquid-based cytology specimens collected using the HPV GenoArray test kit (HybriBio Ltd). This kit is capable of identifying 15 high-risk HPV (hrHPV) types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 65, 66, and 68) [ 11 ]. In this study, patients were categorized as HPV negative, HPV 16/18 and other HR-HPV positive type.…”

Section: Methodsmentioning

confidence: 99%

Assessing colposcopic accuracy for high‐grade squamous intraepithelial lesion detection: a retrospective, cohort study

Bai

Wang

et al. 2022

BMC Women's Health

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Background Inappropriate management of high-grade squamous intraepithelial lesions (HSIL) may be the result of an inaccurate colposcopic diagnosis. The aim of this study was to assess colposcopic performance in identifying HSIL+ cases and to analyze the associated clinical factors. Methods Records from 1130 patients admitted to Shenzhen Maternal and Child Healthcare Hospital from 12th January, 2018 up until 30th December, 2018 were retrospectively collected, and included demographics, cytological results, HPV status, transformation zone type, number of cervical biopsy sites, colposcopists’ competencies, colposcopic impressions, as well as histopathological results. Colposcopy was carried out using 2011 colposcopic terminology from the International Federation of Cervical Pathology and Colposcopy. Logistic regression modelling was implemented for uni- and multivariate analyses. A forward stepwise approach was adopted in order to identify variables associated with colposcopic accuracy. Histopathologic results were taken as the comparative gold standard. Results Data from 1130 patient records were collated and analyzed. Colposcopy was 69.7% accurate in identifying HSIL+ cases. Positive predictive value, negative predictive value, sensitivity and specificity of detecting HSIL or more (HSIL+) were 35.53%, 64.47%, 42.35% and 77.60%, respectively. Multivariate analysis highlighted the number of biopsies, cytology, and transformation zone type as independent factors. Age and HPV subtype did not appear to statistically correlate with high-grade lesion/carcinoma. Conclusion Evidence presented here suggests that colposcopy is only 69.7% accurate at diagnosing HSIL. Even though not all HSIL will progress into cancer it is considered pre-cancerous and therefore early identification will save lives. The number of biopsies, cytology and transformation zone type appear to be predictors of misdiagnosis and therefore should be considered during clinical consultations and by way of further research.

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Section: Methodsmentioning

confidence: 99%

Assessing colposcopic accuracy for high‐grade squamous intraepithelial lesion detection: a retrospective, cohort study

Bai

Wang

et al. 2022

BMC Women's Health

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Section: Discussionmentioning

confidence: 92%

Impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment: post-hoc analysis from a randomized controlled trial

Zhao

et al. 2020

BMC Infect Dis

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Background It is widely acknowledged that HPV prophylactic vaccine could prevent new infections and their associated lesions among women who are predominantly HPV-naive at vaccination. Yet there still remains uncertainty about whether HPV vaccination could benefit to individuals who have undergone surgery for cervical disease. Methods This post-hoc analysis intends to focus on intent-to-treat participants who underwent excision treatment at baseline and the follow-up period in a phase II/III, double-blind, randomized trial (ClinicalTrials.gov, number NCT00779766) conducted in Jiangsu province, China. We evaluate the impact of HPV vaccination on preventing women from subsequent infection and cervical lesions (LSIL+ and CIN2+) after excision treatment. Results One hundred sixty-eight (vaccine, n = 87; placebo, n = 81) performed excisional treatment in this clinical trial. We observed a significant effect of vaccination on acquiring 14 high-risk HPV (HR-HPV) infection after treatment (vaccine efficacy: 27.0%; 95% CI 4.9, 44.0%). The vaccine efficacy against new infections after treatment for 14 HR-HPV infection was estimated as 32.0% (95%CI 1.8, 52.8%), and was 41.2% (95%CI -162.7, 86.8%) for HPV16/18 infection. The accumulative clearance rates of the vaccine group and placebo group were 88.9 and 81.6% for HPV16/18 infection (P = 0.345), 63.4, 48.7% for 14 HR-HPV infection (P = 0.062), respectively. No significant difference was observed on the persistent rate of HPV16/18, 14 HR-HPV infection and occurrence rate of LSIL+ between the two groups. Conclusions No significant evidence from this study showed that HPV-16/18 AS04-adjuvanted vaccine could lead to viral faster clearance or have any effect on the rates of persistent infection among women who had excision treatment. However, the vaccine may still benefit post-treatment women with “primary prophylactic” effect. Further research is required in clarifying the effect of using the prophylactic HPV vaccine as therapeutic agents. Trial registration ClinicalTrials.gov identifier: NCT00779766. Date and status of trial registration: October 24, 2008. Completed; Has Results.

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“…And we used cytological results as an outcome in the analysis due to not all women after treatment underwent colposcopy, which may have potential bias. Based on previous study [24], cytology showed the higher speci city at the cost of lower sensitivity compared to colposcopy, so women without distinct cytological performance would be missed. Additionally, due to the small number of women who received surgery in clinical trials and the fact that loss of follow-up further reduced sample size included in the analysis, we had limited statistical power.…”

Section: Discussionmentioning

confidence: 93%

Impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment: Post-hoc analysis from a randomized controlled trial

Zhao

et al. 2020

Preprint

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Background: It is widely acknowledged that HPV prophylactic vaccine could prevent new infections and their associated lesions among women who were predominantly HPV-naive at vaccination. Yet there still remains uncertainty about whether HPV vaccination could benefit to individuals who had undergone surgery for cervical disease. Methods: This post-hoc analysis intends to focus on intent-to-treat participants who underwent excision treatment at baseline and the follow-up period in a phase II/III, double-blind, randomized trial (ClinicalTrials.gov, number NCT00779766) conducted in Jiangsu province, China. We evaluate the impact of HPV vaccination on preventing women from subsequent infection and cervical lesions (LSIL+ and CIN2+) after excision treatment. Results: 168 (vaccine, n=87; placebo, n=81) performed excisional treatment in this clinical trial. We observed a significant effect of vaccination on acquiring 14 high-risk HPV (HR-HPV) infection after treatment (vaccine efficacy: 27.0%; 95% CI 4.9%, 44.0%). The vaccine efficacy against new infections after treatment for 14 HR-HPV infection was estimated as 32.0% (95%CI 1.8%, 52.8%), and was 41.2% (95%CI -162.7%, 86.8%) for HPV16/18 infection. The accumulative clearance rates of the vaccine group and placebo group were 88.9% and 81.6% for HPV16/18 infection (P=0.345), 63.4%, 48.7% for 14 HR-HPV infection (P=0.062), respectively. No significant difference was observed on the persistent rate of HPV16/18, 14 HR-HPV infection and occurrence rate of LSIL+ between the two groups. Conclusions: No significant evidence from this study showed that HPV-16/18 AS04-adjuvanted vaccine could lead to viral faster clearance or have any effect on the rates of persistent infection among women who had excision treatment. However, the vaccine may still benefit post-treatment women with “primary prophylactic” effect. Further research is required in clarifying the effect of using the prophylactic HPV vaccine as therapeutic agents. ClinicalTrials.gov Identifier: NCT00779766Date and status of trial registration: October 24, 2008 Completed; Has Results

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Evaluation of the accuracy of colposcopy in detecting high-grade squamous intraepithelial lesion and cervical cancer

Cited by 28 publications

References 30 publications

Assessing colposcopic accuracy for high‐grade squamous intraepithelial lesion detection: a retrospective, cohort study

Assessing colposcopic accuracy for high‐grade squamous intraepithelial lesion detection: a retrospective, cohort study

Impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment: post-hoc analysis from a randomized controlled trial

Impact of HPV-16/18 AS04-adjuvanted vaccine on preventing subsequent infection and disease after excision treatment: Post-hoc analysis from a randomized controlled trial

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