Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Colposcopy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed2001

Is colposcopy always necessary with atypical glandular cells of undetermined significance on Papanicolaou smears?

The objective of this study was to review a 5-year experience with atypical glandular cells of undetermined significance (AGUS) on Papanicolaou smear and to use the information to devise a triage method for patients presenting with this abnormality. Our Papanicolaou smear database was used to identify patients who were found to have AGUS results between January 1, 1994 and December 31, 1998. The medical records of these patients were reviewed for the results of follow-up studies, including repeat Papanicolaou smear, endocervical curettage, colposcopic directed biopsies, and endometrial biopsy. During the study period, 27,859 Papanicolaou smears were performed, with 306 (1.1%) being reported as AGUS; 18 patients had two AGUS smears. An additional 24 patients did not meet study criteria. The study group then consisted of 264 patients, of whom 244 (92.4%) reported for follow-up. There were 167 (63.3%) with atypical endocervical cells of undetermined significance (AECUS), 14 (5.3%) with atypical endometrial cells of undetermined significance, and 83 (31.4%) with AECUS plus a squamous cell abnormality. The overall prevalence of a high-grade squamous intraepithelial lesion (HSIL) was 11.8%. The prevalence of HSIL in the AECUS plus squamous cell abnormality group was 25.4%. None of the atypical endometrial cell group had HSIL. In the AECUS, favor dysplasia category, 29.4% had HSIL, whereas in the AECUS, favor reactive process or in unqualified, 2.3% had HSIL. Eighty-one patients underwent endometrial biopsy: three (3.7%) were found to have endometrial adenocarcinoma, and two (2.5%) had complex atypical endometrial hyperplasia. The prevalence of HSIL in patients with AECUS, favor reactive process or AECUS, unqualified Papanicolaou smears is low. Colposcopy is not necessary as an initial triage process for this category of patients. A significant percentage of patients with AECUS, favor dysplasia or AECUS with a squamous epithelial abnormality Papanicolaou smears have HSIL; this subset of patients should be investigated with colposcopy.

Journal Article↗
PubMed1998

Potential hazards of following atypical and low-grade cervical cytology without colposcopy.

Objective: To determine the frequency of high-grade cervical intraepithelial neoplasia in patients with atypical and low-grade cervical cytology and to assess the optimal evaluation and follow-up.Methods: Prospective observational study of 367 of 7,651 private patients who had cytologic, virologic, or colposcopic changes suggesting cervical intraepithelial neoplasia or cervical carcinoma. The study was performed to determine the frequency of cervical intraepithelial neoplasia in the various cytologic groups and to assess the effect of testing for human papillomavirus on the sensitivity, specificity, and positive predictive value of these tests.Results: Papanicolaou smears that included all non-negative tests (high- and low-grade squamous intraepithelial lesions and atypical squamous or glandular epithelial cells of undetermined significance) had the maximal sensitivity (89%) for high-grade cervical intraepithelial neoplasia and cancer. The combined cytologic categories of high- and low-grade squamous intraepithelial lesions had a sensitivity of 58%, this was reduced to 24% if only high-grade squamous intraepithelial lesions were considered relevant for additional evaluation. If we had not evaluated the patients with atypical squamous and glandular cells of undetermined significance, we would have missed diagnosing one third of high-grade and one half of low-grade cervical intraepithelial neoplasia. Cervical cytology was false negative in 8% of patients with high-grade and in 14% of those with low-grade cervical intraepithelial neoplasias. High-risk human papillomavirus deoxyribonucleic acid was detected in 40% of women with high-grade and in 24% of those with low-grade grade cervical intraepithelial neoplasias. The positive predictive value of cytology with atypical squamous cells of undetermined significance increased from 5% to 38% for high-grade and from 30 to 85% for high- and low-grade cervical intraepithelial neoplasias in patients with detectable high-risk human papillomavirus deoxyribonucleic acid. Virologic studies produced no significant improvement on these diagnoses in women with high- or low-grade cytology.Conclusions: Because of the poor sensitivity of cytology suggesting high-grade squamous intraepithelial lesions, we recommend that all women with atypical or low-grade cytology be recalled for colposcopy and high-risk human papillomavirus deoxyribonucleic acid testing, if available. Decisions whether to perform a biopsy should be based on the result of colposcopic examination. Performing colposcopy only on those patients who have cytologic high-grade squamous intraepithelial lesions and following those with lower grade cytologic anomalies without colposcopic diagnosis appears inadequate to rule out high-grade cervical intraepithelial neoplasia.

Journal Article↗
PubMed2000

Microinvasive cervical carcinoma: a retrospective study of cases presenting to the Oxford Colposcopy Unit between 1989 and 1996.

This a retrospective analysis of 65 cases of microinvasive disease and 5-8 years of follow-up (mean 6.2 years), evaluating the effectiveness of cytology and colposcopy in the diagnosis of microinvasive disease and the role of conservative surgery in its management. Cervical cytology reports indicated disease more severe than CIN III in 23% of cases. A further 7% at colposcopy were thought to have possible invasive disease despite no indication from the smear report, this impression correlated with increasing depth of invasion (>1.40 mm).

Journal Article↗
PubMed1997

A study to evaluate Chlamydia screening in colposcopy clinics.

A preliminary study of 329 colposcopy patients was conducted to investigate the prevalence of endocervical chlamydial infection using the VIDAS Chlamydia Enzyme Immune Assay (EIA) and Chlamydia Immune Fluorescent Antigen (IFA) collection kits. The overall antigen positive rates of five of the 329 (1.5%) in the study group compared exactly with the four out of the 260 (1.5%) in the gynaecological outpatient controls. Women in the age group 16-20 years had the highest Chlamydia detection rates (7%) followed by those aged 21-30 years (2.3%). Four of the 119 (3.4%) single women in the study group were Chlamydia antigen positive compared with one of the 210 (0.5%) married women (P < 0.005). Among the controls, three of the 65 (4.6%) single and one of the 195 (0.5%) married women were positive. In both the study and control populations, Chlamydia antigen was more prevalent among younger women and non-contraceptive users. Routine screening in colposcopy patients may not be cost effective, but a policy of selective screening in young single women aged 20 years or less should be considered. Larger sample studies using the more specific and sensitive DNA amplification techniques would have probably yielded higher detection rates and are recommended.

Journal Article↗
PubMed2004

Optimal cutoff of the hybrid capture II human papillomavirus test for self-collected vaginal, vulvar, and urine specimens in a colposcopy referral population.

OBJECTIVE: To estimate the optimal relative light unit ratio, as a measure of viral load, of the Hybrid Capture II human papillomavirus (HPV) test in self-collected specimens for detecting cervical intraepithelial neoplasia (CIN). METHODS: Two hundred women referred for colposcopy with abnormal cytologic, self-collected vaginal and vulvar swabs and urine for HPV testing. The receiver operating characteristic (ROC) curve method was used to estimate optimal cutoffs for the Hybrid Capture II test. The reference standard was colposcopy, with directed biopsy as required. RESULTS: The estimated optimal cutoffs of the relative light unit ratio for detecting CIN 2 or higher for urine, vulvar, and vaginal samples gave sensitivities of 72.4%, 82.8%, and 89.0% and specificities of 57.0%, 52.1%, and 55.9%, respectively. At the manufacturer's recommended 1.0 cutoff, sensitivities were 44.8%, 62.1%, and 86.2% for urine, vulvar, and vaginal samples, with specificities of 69.7%, 62.7%, and 53.5%, respectively. The likelihood ratios (likelihood of being truly positive after a positive test result) were similar for the optimal and the 1.0 cutoff. CONCLUSIONS: The ROC curve methods did not improve the overall diagnostic accuracy of the Hybrid Capture II test compared with the 1.0 relative light unit ratio cutoff.

Journal Article↗
PubMedDate not supplied

A cost-benefit analysis of colposcopy for cervical squamous intraepithelial lesions found on Papanicolaou smear.

BACKGROUND: We performed a cost-benefit analysis of a protocol for studying patients with squamous intraepithelial lesions (SIL) on Papanicolaou smears to determine whether it compared favorably with resources spent on other health programs for screening and treatment. METHODS: During a 3-year period, 424 patients with dysplastic Papanicolaou smears were examined, studied by biopsy, and treated. We calculated costs based on a model protocol and derived a cost per year of life saved for preventing death from invasive cervical carcinoma. A sensitivity analysis was performed on selected assumptions of the analysis. RESULTS: The marginal, or incremental, cost of colposcopic evaluation and treatment of Papanicolaou smears with low-grade SIL, high-grade SIL (moderate), and high-grade SIL (severe), depending on assumptions, ranged from $406 to $5746, $160 to $2263, and $85 to $1197 per year of life saved, respectively. Depending on the assumption of the rate of Papanicolaou smears with SIL in the screened population being 1.8%, 5.1%, or 11.5%, the estimated total cost of screening and treating the referral base was $1.3 million, $538,126, and $307,037, respectively. This results in the average cost per year of life saved to screen and treat low-grade SIL, high-grade SIL (moderate), and high-grade SIL (severe) to be $1105 to $68,909, $375 to $21,673, and $177 to $8831, respectively. CONCLUSIONS: Both marginal cost and average screening costs of evaluating and treating abnormal Papanicolaou smears by the protocol described in this article compare favorably with costs per year of life saved for other health care screening and treatment strategies for many assumptions. The marginal cost to perform colposcopy on patients with a Papanicolaou smear with low-grade SIL is so low that it is relatively a very effective strategy.

Adolescent↗
PubMed1999

A matched prospective study of human immunodeficiency virus serostatus, human papillomavirus DNA, and cervical lesions detected by cytology and colposcopy.

OBJECTIVE: To compare the prevalence and type of human papillomavirus (HPV) infections in the genital tract of human-immunodeficiency-virus- (HIV) seropositive and -seronegative women matched for cytology and to examine prospectively the relationship of HPV DNA, colposcopic findings and cervical squamous intraepithelial lesions (SIL) in these matched seropositive and seronegative cohorts. METHODS: A matched prospective study of HIV-seropositive and -seronegative women undergoing cytologic screening, colposcopy, and testing for HPV DNA and other infections at each visit. RESULTS: Twenty-three HIV-seropositive women were matched with 23 seronegative women by cervical cytology reading, lifetime number of sexual partners, age, and follow-up length. Fourteen pairs of these women had follow-up visits every 4 months, for 56 and 53 total visits in seropositive and seronegative women, respectively. After matching, the groups had a similar overall prevalence of HPV DNA and of HPV oncogenic (high risk) types at baseline. On follow up, HIV-seropositive women were more likely than seronegative women to develop SIL (38% vs. 10%), less likely to have negative cytology (34% vs. 60%, overall P = 0.03), more visits with HPV DNA detected (68% vs. 40% P = 0.04), and more visits with multiple HPV DNA types detected (18% vs. 0%, P = 0.02). Colposcopic lesions in the seropositive women were more likely to have sharp borders or mosaicism or to be thick white (P = 0.009). CONCLUSIONS: After matching for baseline Papanicolaou smear readings, these data suggest that over time seropositive women have more visits that yield abnormal cytology, more persistent HPV DNA detection, and more colposcopic abnormalities than seronegative women.

Adult↗
PubMed1990

Colposcopy, punch biopsy, in situ DNA hybridization, and the polymerase chain reaction in searching for genital human papillomavirus (HPV) infections in women with normal PAP smears.

To assess the prevalence of HPV infection in the genital tracts of women with normal PAP smears, a random series of 109 women was reexamined using colposcopy, a further PAP smear, and punch biopsies taken from the cervix (in 33 cases), vagina (212 cases), and anus (20 cases). The biopsy material was examined using routine histological investigations, in situ hybridization (ISH) with a 35S-labelled DNA probe cocktail (HPV 6, 11, 16, 18), and the polymerase chain reaction (PCR) to detect HPV DNA. Changes consistent with HPV infection were seen in 6.9% (18/262) of the biopsy specimens. Seven biopsy specimens (2.7%) from seven different women were found to contain HPV DNA using ISH. All of these ISH-positive lesions were diagnosed as morphologically characteristic HPV lesions: six flat condylomas and one papillary condyloma. Using PCR, the HPV DNA detection rate was highest in the cervical biopsy specimens (50%) and lowest (28.6%) in the anal biopsy specimens. A total of 35.5% of the 93 biopsy specimens studied using PCR contained HPV DNA. The commonest type was HPV 11 (54.5%), followed by HPV 18 (33.3%). Four of the nine biopsy specimens (44.4%) from colposcopically normal areas proved HPV DNA-positive using PCR. Of 17 biopsy specimens in which the histology was normal, seven were examined using PCR and three were DNA-positive. The discovery of HPV DNA using PCR in 32/92 of the biopsy specimens (34.8%) which had been found to be HPV DNA-negative when routine ISH was used is noteworthy. The results suggest that the light microscopy criteria currently used in diagnosing HPV infections are of no value in predicting latent HPV infections and that acetowhite staining is unable to distinguish between subclinical and latent infections on the one hand and changes unrelated to HPV on the other.

Adult↗
PubMed2002

Detection and genotyping of human papillomavirus DNA by SPF10 and MY09/11 primers in cervical cells taken from women attending a colposcopy clinic.

Human papillomavirus (HPV) is the main etiological agent of cervical cancer. There is a large number of HPV genotypes and therefore a need to distinguish the high risk HPV genotypes associated with invasive cancer from the low risk. Because persistence of high risk HPV infection is necessary for progression of a pre-invasive cervical change one needs to identify the individual genotype to see if it persists. PCR amplification of HPV DNA is described using two consensus primer systems from cervical cells. Amplified HPV DNA was genotyped using a reverse hybridization line probe assay (LiPA). HPV DNA was amplified from 42% of samples by MY09/11 and from 80% by SPF10. In 42 samples HPV DNA was detected by both primer sets and in 38 samples only the SPF10 primers detected HPV DNA. The LiPA detected 21 different HPV genotypes (13 high risk) in this cohort of samples. Forty-three percent contained a single HPV genotype and 24% contained multiple infections (2-5 genotypes). Overall, high risk HPV genotypes were detected in 48% of the cervical samples, the most frequent types were 16, 18, 31, and 51. The proportion of high risk HPV genotypes increased with more severe cytological abnormalities. This study demonstrates that the SPF10 primer set is more sensitive than the MY09/11 primer set and that genotyping by LiPA tells us if the HPV infection is caused by a high risk type and if the infection is mixed. Additionally LiPA provides information about the individual genotype when looking for persistence of infection. HPV DNA detection and genotyping is therefore a useful tool in the colposcopy clinic, used in conjunction with cytology.

Ambulatory Care↗
PubMed1975

[Practical and theoretical viewpoints in computer-analysis of data from colposcopy,, cytology and histopathology (author's transl)].

In collaboration with the IBM (Basel) a computer program was developed for the analysis of data from cytology, colposcopy and histopathology. Due to the general way of formulation the program-system is applicabel for every kind of problem in natural sciences as well as economics. It is written in FORTRAN. Until now 15 parametric and non-parametric statistical tests are available for the analysis of descriptive or analytical statistical questions. The amount of data to be analyzed is nearly unlimited. Several plot-routines incorporated in the program serve for graphical presentation of distributions of different variables, of scatter-diagrams and computed functions. The internal control of the statistical monitor including the report card-system and the syntax of the input orders (with generation of error messages) are shortly explained. In a sample of 251 random selected patients showing pathological signes of the portio uteri from the department of gynecology of the university Basel the way of working of some subroutines is demonstrated and some general principles of data-acquisition and data-management in medicine are outlined.

Cervix Uteri↗
PubMed1986

Colposcopy in the diagnosis of penile condyloma.

To determine the incidence of penile condyloma in a group of high-risk men, we carried out colposcopy and biopsy of suspicious lesions in 51 men. All men were partners of women with condyloma. Of these men, 45 were found to have histologic evidence of condyloma, and only eight of these had grossly visible disease.

Adult↗
PubMed1995

An evaluation of human papillomavirus testing for intermediate- and high-risk types as triage before colposcopy.

OBJECTIVE: Our purpose was to evaluate the role of testing for intermediate- and high-risk human papillomavirus by use of a hybrid capture technique for predicting which patients with abnormal Papanicolaou smears are most likely to have squamous intraepithelial lesions or cancer. STUDY DESIGN: Cervical cytologic studies, hybrid capture tests, and colposcopically directed biopsies were performed on 311 women referred to the colposcopy clinics with abnormal cytologic study results. RESULTS: There was a highly significant correlation (p < 0.0001) between a positive human papillomavirus test and the finding of squamous intraepithelial lesions or invasive cancer. The sensitivity of human papillomavirus testing to detect high-grade squamous intraepithelial lesions was 74% when it was used alone and increased to 91% when coupled with abnormal cytologic study results of low- or high-grade squamous intraepithelial lesions or cancer. In 44 women with atypical squamous cells of undetermined significance on cytologic study, human papillomavirus testing identified six of 10 who had high-grade squamous intraepithelial lesions. For the 96 patients with low-grade squamous intraepithelial lesions, human papillomavirus testing was successful in identifying 29 of the 37 with high-grade squamous intraepithelial lesions (sensitivity 0.76). CONCLUSION: Testing for intermediate- and high-risk human papillomavirus types by hybrid capture improves the detection of high-grade squamous intraepithelial lesions in women with atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions over cytologic study used alone.

Cervix Uteri↗
PubMed1989

Study of the vaginal mucous membrane following tampon utilisation; aspect on colposcopy, scanning electron microscopy and transmission electron microscopy.

The effect of periodic tampons was studied in 17 young women during the menstrual and inter-menstrual cycle. Biopsies (n = 19) were analysed on scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The effect of medium absorbant tampons was compared with that of super-absorbant tampons. On colposcopy, dryness was noted in 89% cases, peeling in 47% cases. Microulcerations were observed only once (5%). Dryness and peeling was most often encountered with the super-absorbant tampons and during the inter-menstrual phase. TEM revealed cellular destruction affecting all layers of the epithelium: lysis of superficial and intermediate cells, destruction of desmosomes accompanied by the creation of inter-cellular spaces, lipidic vacuoles in the lysed cells. SEM revealed epithelial peeling with cleavage and severe cellular desquamation. Cellular anomalies were common at the level of the cytoplasmic membrane, which presented either defects, a porous aspect, or appeared swollen by air-bubbles.

Adult↗
PubMed1989

Test of immunopotentialization in colposcopy--a clinical evaluation.

52 infertile women (age range 19-35 years) treated by Gynatren-immunopotentialization (three vaccinations every second week) were divided into two groups according to appearance of cervical intraepithelial neoplasia (CIN). 30 women had CIN cytologically diagnosed and proved by colposcopy (group II). Colposcopic examinations were performed on the first day of therapy (first vaccination), after two weeks (second vaccination) and after four weeks (the day of the third injection). Four weeks of the therapy resulted in normalization of cervical milieu (e.g., complete regression of infection in 68.2% of I group and 56% of II group) as well as in disappearance of CIN in 66% of cases and in remaining ones there was a 7-times decrease of CIN II. It was colposcopically stated that the process of statistical significant regression of inflammation as well as normalization of cervical pathology is less apparent in women with CIN. These findings confirmed our previous cytological observations.

Adjuvants, Immunologic↗
PubMed1984

Baboon cervical colposcopy, histology, and cytology.

Colposcopic cervical/vaginal examinations were performed on 10 healthy adult baboons. Five of the ten baboons had a "satisfactory" colposcopic cervical examination with columnar epithelium visible on the exocervix. However, only three of five with "satisfactory" colposcopic exams had large visible transformation zones. The colposcopic findings were confirmed by histologic study. Probable squamous metaplasia was seen in one of the four animals who underwent cervical biopsies. The histologic and cytologic similarities of the human and baboon cervical transformation zones were noted. Only the three animals with the large visible cervical transformation zones were considered suitable for colposcopic studies of the transformation zone. Thus only 30% of the baboons examined were considered suitable subjects for studies involving colposcopy. Screening colposcopic exams would be necessary to find this subpopulation of baboons with large transformation zones visible on the exocervix. The implications of this study relative to the use of baboons as an animal model for studies of intraepithelial neoplasia are discussed.

Animals↗
PubMed1985

Colposcopy for postmenopausal women.

The number of postmenopausal women colposcopically diagnosed has markedly increased during the last 15 years. In some of them, a clear colposcopic impression, required for planning an appropriate therapy, was disturbed by severe senile cervicocolpitis, when examined by the conventional technique using acetic acid. With a 5-year experience of 79 paired colposcopies, it was concluded that estrogen administration is necessary as a routine precolposcopic procedure in such cases and oral administration of conjugated estrogens at 1.25 mg/day for 14 days is adequate for this purpose.

Aged↗
PubMed1989

Comparison of repeat smear, colposcopy, and colposcopically directed biopsy in the evaluation of the mildly abnormal smear.

Repeat smear, colposcopy, and colposcopically directed biopsy were performed in 161 patients referred to our department because of a Pap smear showing mild dysplasia (CIN 1). Colposcopically directed biopsies revealed the presence of CIN of different grades in 61 cases (37.5%). In 33 (20.4%) the CIN grade found at biopsy was higher than 1. Repeat smear confirmed the presence of CIN 1 in 67 women (47.2%). In this group of patients colposcopically directed biopsies showed a CIN grade greater than 1 in 12 cases (17.9%). The repeat smear was negative in 59 patients (41.5%). In this group, biopsy showed varying grades of neoplasia in 12 cases. Colposcopic examination indicated no dysplasia but the presence of minor cervical abnormalities in 76 women (47.2%): at biopsy a CIN grade higher than 1 was found in 9 cases (11.5%). These data suggest that the mildly atypical smear identifies a group of patients at increased risk of CIN but gives little or no information on the disease severity. Repeat smear and colposcopic examination alone appear inadequate to demonstrate the severity of the cervical lesion. Due to the high proportion of CIN 2 and 3 in patients with a mildly abnormal smear, the systematic biopsy of any colposcopically abnormal area seems essential to proper management of the patient.

Adult↗
PubMed1990

20-year experience of follow-up of the abnormal smear with colposcopy and histology and treatment by conization or cryosurgery.

During the period 1967 to 1977, 1466 women with Pap smears suggesting cervical epithelial neoplasia (CIN) II or worse were evaluated by colposcopy, portio biopsy, and endocervical curettage. Women who had CIN III were treated first by conization and later by cryosurgery. Cytological diagnosis was inaccurate compared to colposcopical and histological diagnosis, with 27% having a worse histological diagnosis. In 22% of the cases histology was two degrees less or worse than suggested by cytology. Presence of atypical vessels was associated with invasive cancer in 17% of cases. A total of 635 patients were treated by conization. After an average follow-up of 10 years, the cure rate was 96% compared to 87% by cryosurgery (104 cases). Hysterectomy was, mainly because of old age, performed on 154 patients; the cure rate was 97%. Although most treatment failures occurred within the first 5 years, some were seen after as long as 15-20 years.

Adult↗