Objective: To assess the accuracy of colposcopy-assisted biopsy for the diagnosis of cervical intraepithelial neoplasia I (CIN(1)) and to reappraise the correlative factors of missed CIN(2+) in low-grade SIL(squamous intraepithelial lesion)pathologically diagnosed by colposcopy-assisted biopsy.
Methods: A total of 274 women with CIN(1) diagnosed by colposcopy-assisted biopsy and missing scheduled follow-up thus elected to undergo loop electrosurgical excisional procedure (LEEP). Epidemiological data and cervical cytology, high risk human papillomavirus (HR-HPV) detection and colposcopy with directed biopsy and endocervical curettage if necessary prior to LEEP were reviewed and correlation of missed CIN(2+) and all the above factors analyzed.
Results: Among these patients, 85 cases (31.0%) of CIN(2+) were detected. Univariate analysis showed that poor cervical cytology before colposcopy, unsatisfactory colposcopy and positive HR-HPV detection were risk factors of missed CIN(2+) in low-grade SIL pathologically diagnosed by colposcopy-assisted biopsy. Multivariate logistic analysis showed that whether colposcopic examination was satisfactory or not and cervical cytology before colposcopy were independent risk factors of missed CIN(2+) in low-grade SIL pathologically diagnosed by colposcopy-assisted biopsy (OR: 2.06 and 4.67 respectively).
Conclusion: The accuracy of colposcopy-assisted biopsy for the diagnosis of CIN(1) remains poor. Whether colposcopic examination is satisfactory or not and cervical cytology before colposcopy are independent risk factors of missed CIN(2+) in low-grade SIL pathologically diagnosed by colposcopy-assisted biopsy.