Value of colposcopy with dynamic spectral imaging in the detection and evolution of high-grade cervical lesions

ABSTRACT

Objective

To analyze the performance of colposcopy assisted with dynamic spectral imaging (CC-DSI) compared to conventional colposcopy (CC) in diagnosing cervical intraepithelial neoplasia 2+ (CIN2+).

Methods

In total, 973 consecutive women were referred for colposcopy between 2012 and 2016 and were examined simultaneously by CC and CC-DSI; 877 were eligible. Comparisons between CC and CC-DSI were performed against the histological diagnosis performed by either punch biopsy or loop electrosurgical excision procedure (LEEP).

Results

In final histology, 494 women had no CIN, 250 had CIN1 and 133 had CIN2+. The sensitivity to identify women with CIN2+ was significantly higher for CC-DSI compared to CC for the entire group and in the subgroup of 675 women referred with ASCUS or LSIL. In women with HPV16/18 infections, the sensitivity of CC increased with the addition of DSI from 53% to 79% (p < 0.001). Using a multivariant Cox regression model, CC-DSI was an independent factor for progression of the cervical lesions (HR: 2.29, 95% CI 1.07–4.90). Other predictive factors were the number of sexual partners (HR: 1.05, 95% CI: 1.01–1.09) and anal intercourse (HR: 2.45, 95% CI 1.23–5.02).

Conclusion

CC-DSI improves the ability to detect cervical lesions compared to CC and could help predict their potential to progress.

KEYWORDS:

• Colposcopy
• sensitivity
• cervical intraepithelial neoplasia
• dynamic spectral imaging
• HPV
• human papillomavirus
• progression

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Ethics committee

This study has been approved by the Ethics committee of the Hospital Clinico San Carlos no. 13/314-E

Additional information

Funding

This paper was not funded.