Mendoza GBP, González MLE, Erosa CM, Alonso RP

Language: Spanish
References: 25
Page: 587-596
PDF size: 285.73 Kb.

ABSTRACT

Background: Colposcoy is a method of evaluation in women with abnormal cytologies that must be handled with a control system of quality and performed within the acceptable standards.
Objective: To evaluate, through colpo-histopathologic correlation, some quality indicators of colposcopic studies (both diagnostic and operatory) in colposcopic clinic at Hospital General de México.
Material and methods: Longitudinal, retrospective, and descriptive study that analyses 3,142 surgical specimens registered as cervical conizations. Data were presented as percentages and in 2 by 2 tables.
Results: 349 conizations (11.11%) were performed in women with less than 25 years-old, and 10 in women with less than 17 years-old, without a justifiable indication. Colposcopic studies found 2,598 (82.68%) abnormal cases (LGSIL, HGSIL, epidermoid cancer or adenocarcinoma). Among these cases, only 1,163 had a histopathologic verification (colpo-histopathologic correlation of 44.77%, quality control standard › 80%). Difference represents 1,435 false positive colposcopic findings. Among the 544 (17.32%) colposcopic normal cases, in which conization was unjustifiable, histopathologic studies showed that 457 (84%) had some histopathologic abnormality (≥ LGSIL), most of them false negative cases. Colposcopic differentiation between normal vs abnormal findings shows: sensibility 71.79% (low); specificity 5.72% (extremely low); positive predictive value 44.75% (very low); and predictive negative value 15.99% (extremely low). In 75.5% of surgical margins of conizations with diagnosis of › HGSIL there was a disease.
Discussion: Colposcopic practice of this medical group is very poor, and due to this there are a lot of unnecessary conizations performed that represents an unjustifiable waste of human and material resources.
Conclusions: Federal health authorities should regulate colposcopy performance and teaching to guarantee the quality that patients deserve.

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