Association of lesion area measured by colposcopy and cervical neoplasia

• Published in: Journal of obstetrics and gynaecology Vol. 42; no. 2; p. 306
• Main Authors: Mantoani, Priscila Thais S, Jammal, Millena P, Caixeta, Juliana M, Cordeiro, Nayara A, Barcelos, Ana Cristina M, Murta, Eddie Fernando C, Nomelini, Rosekeila S
• Format: Journal Article
• Language: English
• Published: England 17.02.2022
• Subjects: Biopsy; Cervical Intraepithelial Neoplasia - diagnostic imaging; Colposcopy; Female; Humans; Pregnancy; Trachelectomy; Uterine Cervical Neoplasms - diagnostic imaging; biopsy; lesion area; colposcopy; Invasive cervical neoplasia; cervical cancer; cervical intraepithelial neoplasia
• ISSN: 1364-6893
• DOI: 10.1080/01443615.2021.1904218

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 (pixels ) and biopsy result. Fisher's exact test was performed (  < .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 pixels (cut off) with  = .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: 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. This is the first study in the literature that uses the measurement of the lesion area in pixels in comparison with the severity of the lesion, which provides greater accuracy of the lesion area than the mere measurement of its diameter. 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.