เปรียบเทียบความแม่นยำในการตรวจพบรอยโรคระยะก่อนมะเร็งและมะเร็งปากมดลูกจากการตรวจด้วยวิธีเซลล์วิทยา การตรวจด้วยกล้องขยายผ่านทางช่องคลอดและการตัดชิ้นเนื้อ ภายใต้การตรวจด้วยกล้องขยายผ่านทางช่องคลอด

Nicha  Naksukskul

Authors

Nicha Naksukskul Obstetrics and Gynecology Department, Phaholpolpayuhasena Hospital, Kanchanaburi Province

Abstract

Conventional cytology is the most feasible and available tool for cervical cancer screening in Thailand. Women with abnormal cytology receive a colposcopic examination and colposcopic directed biopsy of the cervix. However, there have been few comparative studies conducted on the accuracy of conventional cytology, colposcopy, and colposcopic directed biopsy. Therefore, the objective of this study was to compare the accuracy of these three methods, conventional cytology, colposcopy, and colposcopic directed biopsy, in detecting precancerous and cancerous lesions. Pathology reports from a loop electrosurgical excision procedure (LEEP) were used as the gold standard. In this cross-sectional study, the data of patients who were diagnosed with cervical intraepithelial neoplasia (CIN) grades 1, 2, or 3 by colposcopic directed biopsy and underwent LEEP between January 2016 and December 2020, totaling 318 cases, was collected from medical records. The results of the study regarding the accuracy, sensitivity, and specificity were analyzed by statistical methods. The accuracy of conventional cytology, colposcopy, and colposcopic directed biopsy was 74.5%, 70.6%, and 87.4%, respectively. The sensitivity of each method was found to be 58.6%, 73.7%, and 83.1%, respectively. The specificity of each method was calculated as 91.5%, 66.7%, and 92.1%, respectively. In conclusion, this study demonstrated that colposcopic directed biopsy has the highest diagnostic accuracy, sensitivity, and specificity for detecting CIN 2 or higher lesions compared to conventional cytology and colposcopy.

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