Clinical evaluation of borderline nuclear changes in cervical smears at colposcopy and biopsy

Abstract

The aim of this study was to determine the incidence of cervical intraepithelial neoplasia at colposcopy and biopsy in woman with smears showing borderline nuclear changes to assess the predictive rate of colposcopy in identifying CIN and to verify the importance of follow-up. A retrospective study of 134 cases referred for colposcopic assessment with borderline nuclear changes in smears was carried out. Of the 134 patients studied, 44·8% had cervical intraepithelial neoplasia and 30% had benign changes of the cervix; 25·5% of cases were normal, 14% of the study population had HPV infection confirmed by biopsy. Of all cases of CIN, 38% were diagnosed to have low grade abnormalities, 6·8% had high-grade abnormalities. The predictive rate of colposcopy in identifying low-grade abnormalities was approximately 60% and 80·7% had a normal smear after 6 months, follow-up. As cervical intraepithelial neoplasia was found in a significant number of patients, borderline changes in cervical smears need subsequent evaluation. Even though more than two-thirds of women had negative smears at 6-month follow-up, the study recommends annual follow-up smears for several years as the long-term risk is not definitely known.