Analysis of Diagnostic Differences between Colposcopy Beginner and Pathologic Report in Cervical Disease / 实用妇产科杂志

ABSTRACT

Objective:To evaluate the consistency of colposcopy diagnosis performed by a single examiner with pathologic diagnosis and to analyze the factors related with colposcopy over-and under diagnosis.Methods:A retrospective study was performed.The initial 200 cases diagnosed by a single colposcopy beginner at Peking University first Hospital out-patient clinic from March 2015 to October 2015 were included in this study.The consistency rate and bias rate of colposcopy diagnosis versus pathologic diagnosis as well as the causes of such differences were analyzed.Results:Of 174 cases with pathologic diagnosis,the consistency rate was 59.2％.The underdiagnosis rate and overdiagnosis rate were 18.4％ and 22.4％ separately.Of HSIL underdiagnosis group,the rate of TCT NILM was 78.6％ which was higher than 18.1％ in HSIL consistency group,P ＜ 0.05.Re-evaluation of the colposcopy pictures revealed that acetowhite epithelium were present in all 14 cased of HSIL underdiagnosis group.The rate of post-menopausal women was higher in HSIL underdiagnosis group than in HSIL consistency group(21.4％ vs 0％),P ＜0.05.The medium numbers of biopsy were higher in HSIL consistency group when compared with HSIL underdiagnosis group,P ＜0.05.The medium numbers of biopsy was higher in overdiagnosis group when compared with consistency group,P ＜ 0.05.Conclusions:Underdiagnosis of colposcopy was related with TCT-overdependent,insufficient understanding of acetowhite epithelium and post-menopausal women.Increasing biopsy numbers may improve the consistency rate of colposcopy and pathologic diagnosis.However,the increasing numbers of biopsy often results from overdiagnosis.