Article Data

  • Views 491
  • Dowloads 103

Original Research

Open Access

Are colposcopy and electrical impedance spectroscopy complementary when used to detect high-grade cervical neoplasia?

  • J.A. Tidy1,*,
  • B.H. Brown2
  • R.E. Lyon1
  • T.J. Healey3
  • J.E. Palmer1

1Colposcopy Clinic, Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield (United Kingdom)

2Medical Physics, University of Sheffield, Sheffield (United Kingdom)

3Medical Physics, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield (United Kingdom)

DOI: 10.12892/ejgo3882.2018 Vol.39,Issue 1,February 2018 pp.70-75

Published: 10 February 2018

*Corresponding Author(s): J.A. Tidy E-mail: ohn.tidy@sth.nhs.uk

Abstract

Purpose of investigation: To evaluate if colposcopy and electrical impedance spectroscopy (EIS) are complementary and hence increase the detection of high-grade cervical intraepithelial neoplasia (HG-CIN). Materials and Methods:A cohort of 1,237 women with an abnormal cervical cytology result referred to a single colposcopy service to assess the value of EIS as an adjunct to colposcopy for the detection of HG-CIN. Results: Fifty-three (12.8%) extra cases of HG-CIN were detected by a combination of colposcopy and EIS (466 vs. 413). Ten cases were referred with high-grade cytology and 43 were associated with low-grade cytology. The increased detection of HG-CIN in women referred with low-grade cytology was 50% (129 vs. 86). The combination of colposcopy and EIS produced a highly significant improvement in the detection of HG CIN. Conclusions: Comparison of the performance metrics with a previous multi-centre trial shows that use of EIS as an adjunct increases performance over that obtained from colposcopy alone. The largest improvement is in increased sensitivity and NPV when used to detect HG-CIN, particularly in women referred with low-grade cytology.

Keywords

Cervical smear; Colposcopy; Cervical intraepithelial neoplasia; Electrical impedance spectroscopy; Treatment; Loop electrosurgical excision procedure.

Cite and Share

J.A. Tidy,B.H. Brown,R.E. Lyon,T.J. Healey,J.E. Palmer. Are colposcopy and electrical impedance spectroscopy complementary when used to detect high-grade cervical neoplasia?. European Journal of Gynaecological Oncology. 2018. 39(1);70-75.

References

[1] Mitchell M.F., Schottenfeld D., Tortolero-Luna G., Cantor S.B., Richards-Kortum R.: “Colposcopy for the diagnosis of squamous intraepithelial lesions: a meta-analysis”. Obstet Gynecol., 1998, 91, 626.

[2] ASCUS-LSIL Triage Study (ALTS) Group: “A randomized trial on the management of low-grade squamous intraepithelial lesion cytology interpretations”. Am. J. Obstet. Gynecol., 2003, 188, 1393.

[3] Bekkers R.L., van de Nieuwenhof H.P., Neesham D.E., Hendriks J.H., Tan J., Quinn M.A.: “Does experience in colposcopy improve identification of high grade abnormalities?” Eur. J. Obstet. Gynecol. Reprod. Biol., 2008, 141, 75.

[4] Cantor S.B., Cardenas-Turanzas M., Cox D.D., Atkinson E.N., Nogueras-Gonzalez G.M., et al.: “Accuracy of colposcopy in the diagnostic setting compared with the screening setting”. Obstet. Gynecol., 2008, 111, 7.

[5] Pretorius, R.G., Belinson J.L., Burchette R.J., Hu S, Zhang X., Qiao Y.L.: “Regardless of skill, performing more biopsies increases the sensitivity of colposcopy”. J. Low. Genit. Tract Dis., 2011, 15, 180.

[6] Pretorius R.G., Zhang W.H., Belinson J.L., Huang M.N., Wu L.Y., Zhang X., et al.: “Colposcopically directed biopsy, random cervical biopsy, and endocervical curettage in the diagnosis of cervical intraepithelial neoplasia II or worse”. Am. J. Obstet. Gynecol., 2004, 191, 430.

[7] Wentzensen N., Walker J.L., Gold M.A., Smith K.M., Zuna R.E., Mathews C., et al.: “Multiple biopsies and detection of cervical cancer precursors at colposcopy”. J. Clin. Oncol., 2015, 33, 83.

[8] van der Marel J., Rodriguez A., Del Pino M., van Baars R., Jenkins D., van de Sandt M.M., et al.: “The value of endocervical curettage in addition to biopsies in women referred to colposcopy”. J. Low. Genit. Tract Dis., 2015, 19, 282.

[9] The TOMBOLA (Study Of Management of Borderline and Other Low-grade Abnormal smears) Group: “After-effects reported by women following colposcopy, cervical biopsies and LLETZ: results from the TOMBOLA study”. BJOG, 2009, 116, 1506.

[10] Huh W.K., Ault K.A., Chelmow D., Davey D.D., Goulart R.A., Garcia F.A., et al.: “Use of primary high-risk human papillomavirus testing for cervical cancer screening: interim clinical guidance”. Obstet. Gynecol., 2015, 125, 330.

[11] Australian Government Department of Health: “National Cervical Screening Program”. Available at http://www.cancerscreening. gov.au/internet/screening/publishing.nsf/Content/future-changescervical

[12] The Netherlands Cervical Cancer Screening Programme: “Feasibility study for improvements to the population screening for cervical cancer 2013” Available at: http://www.rivm.nl/ Documenten_en_publicaties/Wetenschappelijk/Rapporten/2014/septembe /Feasibility_ study_for_improvements_to_the_population_screening_for_cervical_ cancer_2013

[13] Public Health England: “Cervical screening: programme and colposcopy management”. NHSCSP publication 20, 2016. Available at: https://www.gov.uk/ government/publications/cervical-screeningprogramme-and-colposcopy-management

[14] Porras C., Wentzensen N., Rodriguez A.C., Morales J., Burk R.D., Alfaro M., et al.: “Switch from cytology-based to HPV-based cervical screening: Implications for colposcopy”. Int. J. Cancer, 2012, 130, 1879.

[15] Leeson S.: “Advances in colposcopy: new technologies to challenge current practice”. Eur. J. Obstet. Gynecol. Reprod. Biol., 2014, 182, 140.

[16] van der Marel J., van Baars R., Quint W.G.V., Berkhof J., del Pino M., Torne A., et al.: “The impact of human papillomavirus genotype on colposcopic appearance: a cross-sectional analysis”. BJOG, 2014, 121, 1117.

[17] Jeronimo J., Bansil P., Valdez M., Kang L.N., Zhao F.H., Qiao Y.L., et al.: “The infuence of human papillomavirus genotypes on visual screening and diagnosis of cervical precancer and cancer”. J. Low. Genit. Tract Dis., 2015, 19, 220.

[18] Walker D.C., Brown B.H., Blackett A.D., Tidy J., Smallwood R.H.: “A study of the morphological parameters of cervical squamous epithelium”. Physiol. Meas., 2003, 24, 121.

[19] Brown B.H., Tidy J., Boston K., Blackett A.D., Smallwood R.H., Sharp F.: “The relationship between tissue structure and imposed electrical current flow in cervical neoplasia”. Lancet, 2000, 355, 892.

[20] Brown B.H., Milnes P., Abdul S., Tidy J.: “Detection of cervical intraepithelial neoplasia using impedance spectroscopy – prospective study”. BJOG, 2005, 112, 802.

[21] Abdul S., Brown B.H., Milnes P., Tidy J.: “The use of electrical impedance spectroscopy in the detection of cervical intraepithelial neoplasia”. Int. J. Gynecol. Cancer, 2006, 16, 1823.

[22] Balasubramani L., Brown B.H., Healey J., Tidy J.A.: “The detection of cervical intraepithelial neoplasia by electrical impedance spectroscopy: the effects of acetic acid and tissue homogeneity”. Gynecol. Oncol., 2009, 115, 267.

[23] Tidy J.A., Brown B.H., Healey T.J., Daayana S., Martin M., Prendiville W., et al.: “Accuracy of detection of high-grade cervical intraepithelial neoplasia using electrical impedance spectroscopy with colposcopy”. BJOG, 2013, 120, 400.

[24] Kelly R.S., Patnick J., Kitchener H.C., Moss S.M. on behalf of the NHSCSP HPV Special Interest Group: “HPV testing as a triage for borderline or mild dyskaryosis on cervical cytology: results from the Sentinel Sites Study”. Br. J. Cancer, 2011, 105, 983.

[25] Cancer Research UK: “Cervical cancer statistics”. Available at: http://www.cancerresearchuk.org/health-professional/cancerstatistics/ statistics-by-cancer-type/cervical-cancer

[26] Ebisch R.MF., Rovers M.M., Bosgraaf R.P., van der Pluijm-Schouten H.W., Melchers W.J.G., van den Akker P.A.J., et al.: “Evidence supporting see-and-treat management of cervical intraepithelial neoplasia: a systematic review and meta-analysis”. BJOG, 2016, 123, 59.

[27] Nooij L.S., Kagie M.J.: “‘See and treat’ approach for high-grade squamous intraepithelial cervical lesions”. Eur. J. Gynecol. Oncol., 2016, 37, 22.

[28] Balasubramani L., Orbell S., Haggar M., Brown V., Tidy J.: “Do women with high grade CIN prefer a See and Treat option in colposcopy?” BJOG, 2007, 114, 39.

[29] Cullimore J., Scurr J.: “The abnormal glandular smear: cytologic prediction, colposcopic correlation and clinical management”. J. Obstet. Gynaecol., 2000, 20, 403.

[30] Ullal A., Roberts M., Bulmer J.N., Mathers M.E., Wadehra V.: “The role of cervical cytology and colposcopy in detecting cervical glandular neoplasia”. Cytopathology, 2009, 20, 359.

[31] Talaat A., Brinkmann D., Dhundee J., Hana Y., Bevan J., Irvine R., et al.: “Risk of significant gynaecological pathology in women with glandular neoplasia on cervical cytology”. Cytopathology, 2012, 23, 371.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time

Conferences

Top