The Accuracy And Influencing Factors Of Colposcopy In The Diagnosis Of Vulvar Lesions

Objective:To evaluate the accuracy and influencing factors of colposcopy in the diagnosis of vulvar lesions.Methods:A retrospective analysis of 1587 cases of gynecology outpatients.All patients were underwent colposcopy,HPV-DNA and vulvar biopsy.Comparison the colposcopy results with pathological biopsy,evaluating the diagnostic value of colposcopy through sensitivity,specificity,negative predictive value and positive predictive value.Results:According to the pathological biopsy Of the 1587 cases,nonneoplastic epithelial disorders of vulva in 1436 cases(90.5%),LSIL of the vulva in 145 cases(9.1%),HSIL of the vulva in 13 cases(0.8%),and 4 cases of vulva cancer(0.3%).For nonneoplastic epithelial disorders of vulva,the sensitivity was 98.5%,specificity was 86.8%,positive predictive value was 98.6%,negative predictive value was 85.6%,and missed diagnosis rate of colposcopy were 1.5%,the AUC was 0.93.For vulvar intraepithelial neoplasia(VIN),the sensitivity was 94.4%,specificity was 93.8%,positive predictive value was 62.9%,negative predictive value was 99.3%,and missed diagnosis rate of colposcopy were 5.6%,the AUC was 0.94(?2=2060.136,P=0.000).When combine with vulvar inflammation,the diagnosis sensitivity and specificity for nonneoplastic epithelial disorders of vulva and VIN reduces obviously(nonneoplastic epithelial disorders of vulva: sensitivity 99.0% vs 96.5%,specificity 88.3% vs 71.4%,?2=25.658,P=0.000;VIN:sensitivity 95.2% vs 84.6%,specificity 97.8% vs 79.8%,?2=161.413,P=0.000).Conclusion:This results shows that the colposcopy had high sensitivity and specificity,which in both nonneoplastic epithelial disorders of vulva and VIN.Vulvar inflammation has an effect on the accuracy of colposcopy diagnosis.It suggests that the accuracy of colposcopy can be improved after the inflammation gets controlled.