Inner Border-A Specific and Significant Colposcopic Sign for Moderate or Severe Dysplasia (Cervical Intraepithelial Neoplasia 2 or 3)

Scheungraber, Cornelia; Glutig, Katja; Fechtel, Beatrix; Kuehne-Heid, Rosemarie; Duerst, Matthias; Schneider, Achim

doi:10.1097/lgt.0b013e31817ff92a

Cited by 16 publications

(9 citation statements)

References 7 publications

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“…We analyzed these specific signs in detail, and the specificity and PPV of both signs were high. Other studies have confirmed the clinical utility of these criteria and their strong association with HSIL [ 22 – 25 ]. With regard to other minor changes and major changes , the incidence of a thin acetowhite epithelium was the highest (65.4%).…”

Section: Discussionmentioning

confidence: 75%

Diagnostic value of the 2011 International Federation for Cervical Pathology and Colposcopy Terminology in predicting cervical lesions

et al. 2018

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ObjectiveTo evaluate the diagnostic accuracy of the 2011 International Federation for Cervical Pathology and Colposcopy (IFCPC) colposcopic terminology.MethodsThe clinicopathological data of 2262 patients who underwent colposcopy from September 2012 to September 2016 were reviewed. The colposcopic findings, colposcopic impression, and cervical histopathology of the patients were analyzed. Correlations between variables were evaluated using cervical histopathology as the gold standard.ResultsColposcopic diagnosis matched biopsy histopathology in 1482 patients (65.5%), and the weighted kappa strength of agreement was 0.480 (P<0.01). Colposcopic diagnoses more often underestimated (22.1%) than overestimated (12.3%) cervical pathology. There was no significant difference between the colposcopic diagnosis and cervical pathology agreement among the various grades of lesions (P=0.282). The sensitivity, specificity for detecting high-grade lesions/carcinoma was 71.6% and 98.0%, respectively. Multivariate analysis showed that major changes were independent factors in predicting high-grade lesion/carcinoma, whereas transformation zone, lesion size, and non-stained were not statistically related to high-grade lesion/carcinoma.ConclusionsThe 2011 IFCPC terminology can improve the diagnostic accuracy for all lesion severities. The categorization of major changes and minor changes is appropriate. However, colposcopic diagnosis remains unsatisfactory. Poor reproducibility of type 2 transformation zone and the significance of leukoplakia require further study.

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Section: Discussionmentioning

confidence: 75%

Diagnostic value of the 2011 International Federation for Cervical Pathology and Colposcopy Terminology in predicting cervical lesions

et al. 2018

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“…Introduction of the two new signs, "inner border sign" and "ridge sign" to the grade 2 (major lesions) section, was the result of their significant validity as markers of high-grade cervical intraepithelial neoplasia. 22,23 Sharp border has also been associated with a more severe lesion. The term leukoplakia or keratosis was considered a major lesion in the first and second International Federation of Cervical Pathology and Colposcopy terminologies 2,3 but was reclassified in 2002 in the third International Federation of Cervical Pathology and Colposcopy terminology, 4 under "miscellaneous findings," to diminish its significance.…”

Section: Discussionmentioning

confidence: 95%

2011 Colposcopic Terminology of the International Federation for Cervical Pathology and Colposcopy

Bornstein

Bentley

Bösze

et al. 2012

Obstetrics & Gynecology

374

291

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New colposcopy terminology was prepared by the Nomenclature Committee of the International Federation of Cervical Pathology and Colposcopy after a critical review of previous terminologies, online discussions, and discussion with national colposcopy societies and individual colposcopists. This document has been expanded to include terminology of both the cervix and vagina. The popular terms "satisfactory colposcopy" and "unsatisfactory colposcopy" have been replaced. The colposcopic examination should be assessed for three variables: 1) adequate or inadequate, with the reason given; 2) squamocolumnar junction visibility; and 3) transformation zone type. Other additions were the localization of the lesion to either inside or outside the transformation zone and determinants of size as well as location of cervical lesions. Two new signs were included in the terminology-the "inner border sign" and "ridge sign." The following definitions have been added: congenital transformation zone, polyp (ectocervical or endocervical), stenosis, congenital anomaly, and posttreatment consequence. In addition, the terminology includes standardization of cervical excision treatment types and cervical excision specimen dimensions. The International Federation of Cervical Pathology and Colposcopy recommends that the 2011 terminology replace all others and be implemented for diagnosis, treatment, and research.

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“…Overall, the new colposcopic nomenclature more clearly emphasises the significance of colposcopic examinations than did the preceding version. Especially gratifying is the fact that two current publications from Germany-speaking countries (Scheungraber et al [3,4]) have been duly incorporated in the revision of the nomenclature. It should also be mentioned that the practically important differentiation between the localisation of lesions inside and outside of the transformation zones has been explicitly described in the nomenclature and also that the significance of the surface expansion of dysplasia in cervix uteri has been scientifically confirmed by publications from German-speaking countries [10,11].…”

Section: Zusammenfassungmentioning

confidence: 99%

“…It should be noted critically that making the diagnosis of metaplasia actually necessitates a prior histological clarification in order to prove the existence of the metaplasia and exclude other functional findings, e.g., hyperplastic or polypous ectopy. In abnormal colposcopic findings, the localisation of the lesioninside or outside the transformation zonehas been re-included in the nomenclature and supplemented with the terms "inner border" (border within the acetic-white epithelium) and "ridge sign" [3,4]. The size of the lesion has been incorporated in the nomenclature whereby the dimensions of the lesion are to be given as number of afflicted quadrants or, respectively, as percentage of the cervix.…”

Section: Zusammenfassungmentioning

confidence: 99%

Explanation and Use of the Colposcopy Terminology of the IFCPC (International Federation for Cervical Pathology and Colposcopy) Rio 2011

Quaas¹,

Reich²,

Tirri³

et al. 2013

Geburtsh Frauenheilk

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In July 2012 a revised terminology on colposcopic examinations of the cervix uteri was adopted by IFCPC. Central aspect is a description of characteristics that should aid in the definition of the disease entity cervix uteri. The nomenclature is built up in such a way that the examiner can evaluate colposcopic criteria according to a specific scheme. Firstly it is assessed whether the colposcopy is representative. Then it should be clarified whether or not the findings are normal. If the findings are not normal but rather abnormal the severity of the lesion is classified according to the so-called grade 1 (minor change) and grade 2 findings (major change). Specific abnormal findings such as leukoplakia, erosion and Lugol?s finding are also not defined at this point. Characteristics suspicious for an invasion are described separately, in particular, atypical vessel patterns are mentioned here. As already held in the previous revised nomenclature (Barcelona), various findings are described in a last group: congenital transformation zones (CTZ), congenital anomalies, condylomas (papillomas), endometriosis, polyps (ectocervical, endocervical), inflammation, stenosis, postoperative changes (scarred portio, vaginal stump).

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Inner Border-A Specific and Significant Colposcopic Sign for Moderate or Severe Dysplasia (Cervical Intraepithelial Neoplasia 2 or 3)

Abstract: Inner border is a rare colposcopic phenomenon but highly specific for CIN 2 or 3 in young women.

Cited by 16 publications

References 7 publications

Diagnostic value of the 2011 International Federation for Cervical Pathology and Colposcopy Terminology in predicting cervical lesions

Diagnostic value of the 2011 International Federation for Cervical Pathology and Colposcopy Terminology in predicting cervical lesions

2011 Colposcopic Terminology of the International Federation for Cervical Pathology and Colposcopy

Explanation and Use of the Colposcopy Terminology of the IFCPC (International Federation for Cervical Pathology and Colposcopy) Rio 2011

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