Association of lesion area measured by colposcopy and cervical neoplasia

Abstract

Studies have demonstrated that the size of lesion in colposcopic imaging can be associated with the grade of CIN. We evaluated 36 patients and at the time of colposcopy, the images were recorded and analysed for lesion area measurement. A ROC curve was used to obtain the area under the curve and to determine the best cut-off values between area lesion (pixels²) and biopsy result. Fisher's exact test was performed (p < .05). Half of the sample had a cervical biopsy showing HPV or LSIL, and 18 (50%)a biopsy showing HSIL or invasive cancer. HSIL and invasive cancer were associated with a lesion area greater than 30,337.03 pixels² (cut off) with p = .04. Thus the area of the colposcopic lesion is related to the severity of that; so small lesions can be more conservatively followed.

IMPACT STATEMENT:

• What is already known on this subject? Studies have proposed that the size of lesion in colposcopic imaging can be associated with the grade of CIN, and the size of CIN lesions may be a factor in determining the risk of progression.

• What do the results of this study add? This is the first study in the literature that uses the measurement of the lesion area in pixels² in comparison with the severity of the lesion, which provides greater accuracy of the lesion area than the mere measurement of its diameter.

• What are the implications of these findings for clinical practice and/or further research? The size of the lesion should be considered in the management of cervical intraepithelial lesions. This approach also leads to lower cost and is less invasive. Small lesions will have the best prognosis and would be treated in the way more conservative, bringing to the patients more comfort and less complications with the treatment.

Keywords:

• Invasive cervical neoplasia
• cervical intraepithelial neoplasia
• lesion area
• colposcopy
• biopsy
• cervical cancer

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The authors wish to acknowledge the funding received from the CNPq (Conselho Nacional de Desenvolvimento Científico e Tecnológico), FUNEPU (Fundação de Ensino e Pesquisa de Uberaba), FAPEMIG (Fundação de Amparo à Pesquisa do Estado de Minas Gerais), and CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil).