|Diagnostic Value of Pap Smear and Colposcopy in Non-Benign Cervical Lesions|
|Manizheh Sayyah-Melli, Vahideh Rahmani, Elaheh Ouladsahebmadarek, Mehri Jafari-Shobeiri, Parvin Mostafa Gharabaghi, Maryam Nooshin Vahidi|
|Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran|
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Keywords : Pap smear, colposcopy, biopsy, cervix
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Objectives: Although cervical cancer is a very common and lethal condition, owing to longstanding premalignant lesions, preventing morbidity and mortality by screening measures is feasible. Pap smear, colposcopy and biopsy are among main modalities in this regard, but there is still no consensus on the diagnostic utility of the first two methods. This study sought to examine the diagnostic utility of Pap smear and colposcopy to cytology in evaluating non-benign cervical lesions.
Methods: A cross sectional study was carried out between 2014 and 2016 in an out-patient setting at the Alzahra Teaching Hospital of the Tabriz University of Medical Sciences. After obtaining informed consent, all 0f 315 participants with abnormal Pap testwere underwent colposcopy and biopsy from the abnormal areas. Cervical biopsy was considered as gold standard and the diagnostic valueof Pap smear and colposcopy was individually compared by calculating sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio.
Results: The mean age of patients was 38.49±10.31 years (range, 17-68). On the basis of biopsy findings, non-benign cervical lesions were present in 31 cases (9.8%). Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value,andpositive likelihood ratio of Pap smear in revealing non-benign cervical lesions was 77.4%, 69.7%, 21.8%, 95.6%, 70.7%, and 2.55%, and for colposcopy, was 90.3%, 90.9%, 51.9%, 98.9%, 90.8%,and 99.2%, respectively.
Conclusion: According to our results, the colposcopy is a sensitive and specific method in differentiating benign cervical lesions from non-benign cervical lesions. The accuracy of Pap smear is intermediate in this regard, and the utility is limited and this method should not be considered as aprincipal factor intherapeutic decision making.
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