Clinical Efficacy of Cervicography in Patients with Atypical Squamous Cells of Undetermined Significance (ASCUS) on Cervical Cytology

Park, Ho Beom; Suh, Young Hoon; Park, Choong Hak

Abstract

OBJECTIVE
The purpose of this study was to investigate the correlation between the cervicographic diagnoses and histologic diagnoses in patients with ASCUS cytologic diagnosis according to The Bethesda System.
METHODS
This study was performed in outpatient clinic of Department of Obstetrics and Gynecology at Dankook University Medical Center from January 1, 2000 to July 31, 2000. Of the 120 patients who underwent both conventional Papanicolaou cervical cytologic test and cervicographic examination, 30 cases with ASCUS cytologic diagnosis were analyzed. Cervicographic diagnoses were compared with histologic diagnoses as a reference standard.
RESULTS
Followings are the results summarized. 1. Age distribution was between 26 and 62. The mean age was 43.1 years. 2. The mean gravidity was 4.5 and the mean parity was 2.5. 3. There were 19 (63.3%) cervicographic diagnoses of Negative, 6 (20.0%) of Atypical, and 5 (16.7%) of Positive. Of the 5 Positive diagnoses, there were 3 cases of P0 and 2 cases of P1. 4. There were 1 (3.3%) histologic diagnosis of WNL, 23 (76.7%) diagnoses of cervicitis, 3 (10.0%) of LSIL, and 3 (10.0%) of HSIL. 5. Of the 19 cervicographic diagnoses of Negative, there were 17 histologic diagnoses of cervicitis, and 2 of LSIL. Of 6 cases of Atypical, there were 4 histologic diagnoses of cervicitis and 2 of HSIL. Of 5 cases of Positive, there were 3 histologic diagnoses of cervicitis, 1 of LSIL, and 1 of HSIL. 6. Cervicography for detecting LSIL or worse yielded sensitivity of 33.3%, specificity of 87.5%, positive predictive value of 40.0%, and negative predictive value of 84.0%.
CONCLUSION
There was no statistical significance because of small data. Cervicography does not seem to replace conventional Papanicolaou cervical cytologic screening test or play an adjunctive role for detection of LSIL or worse in patients with ASCUS on cervical cytology. But a multicenter study with large data will be required to get the proper conclusion.