Accuracy of Colposcopically Directed Biopsy in Diagnosis of Cervical Pathology at Srinagarind Hospital

Objective: To determine the accuracy of colposcopically directed biopsy (CDB) in diagnosis of precancerous or cancerous lesion of the uterine cervix as a quality index of the institute. Materials and
Methods: We retrospectively reviewed the medical records of the women who had colposcopic examination at the Department of Obstetrics and Gynecology, Srinagarind Hospital from January, 2005 to December, 2010. The women with satisfactory colposcopic examination who had CDB and further interventions such asloop electrosurgical excision procedure (LEEP)/conization, and/or hysterectomy were included in study. The pathological reports of the specimens from CDB were analyzed comparing with LEEP/conization or hysterectomy according to the highest degree of abnormalities. Pathological reports of HSIL (high grade squamous intraepithelial lesion) or more severe wereclassified as positive, while LSIL (low grade squamous intraepithelial lesion) or less severe were classified as negative.
Results: There were 320 patients included, 259 having highest pathological reports of HSIL or more. The accuracy of CDB to detect HSIL or more of the uterine cervix was 87.8% with sensitivity, specificity, PPV and NPV of 84.9%, 100%, 100%, and 61%, respectively.
Conclusions: The accuracy of CDB in diagnosis of cervical pathology in our institute was acceptable and comparable to those of others. CDB is a reliable method to obtain the pathological diagnosis in women with abnormal cervical cytologic screening.