The value of microendoscopy in the diagnosis of cervical precancerous lesions and cervical microinvasive carcinoma

Abstract

Purpose

Cervical cancer is still one of the main causes of death in females. Conventional diagnostic tools such as colposcopy are still unsatisfactory, so accurate diagnostic tools for cervical diseases are needed. Therefore, the purpose of this study was to perform a clinical study to evaluate the value of microendoscopic imaging systems in the diagnosis of cervical precancerous lesions and cervical microinvasive carcinoma (MIC).

Methods

Totally 106 patients ranging in age from 23 to 67 years were recruited. All patients had abnormal thin-layer cytology (TCT) results (≥ low-grade squamous intraepithelial lesions) and high-risk human papillomavirus (HPV) positivity. Each patient was first subjected to ordinary colposcopy, followed by microendoscopy and biopsy. All results of the colposcopy and microendoscopy images were compared to the histopathological diagnosis.

Results

Characteristics of pathological blood vessels were easily distinguished by microendoscopy compared with ordinary colposcopy. The diagnostic agreement rate of microendoscopy with the pathological diagnosis was higher (95.3%) than that of ordinary colposcopy (37.7%) (weighted kappa = 0.863, P < .01). When diagnosing HSIL and more advanced disease, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the microendoscopic diagnosis were significantly higher than those of ordinary colposcopy (97.6 and 38.1%), (95.5 and 63.6%), (98.8 and 80.0%), (91.3 and 21.2%) and (97.7 and 43.4%), respectively.

Conclusion

This study shows that microendoscopy has important value in the diagnosis of cervical lesions which can provide real-time diagnosis in vivo without staining, particularly for lesions that are not sensitive to acetic acid staining.

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Funding

This work was supported by National Natural Science Foundation of China (Grant NO. 81771529), Shanghai Science and Technology Development Foundation (Grant NO. 17441902500), Shanghai Hospital Development Center Foundation (Grant NO. 16CR3089B), Fundamental Research Funds for the Central Universities (Grant NO. 22120190241 and 22120190214), National Natural Science Foundation of China (Grant NO. 81974414).

Author information

Affiliations

Authors

Contributions

JG: study design, data collection, data analysis, writing.; LF: study design, data analysis, Writing; JZ and LL: microendoscopy diagnosis; QZ, ML and YR: clinical data collection; HL and JX: colposcopy diagnosis; NL and HW: microendoscopy research and development; HZ: the design of the study, the implementation of clinical treatment, article guidance and modification, statistical guidance and modification, Pathological diagnosis; ZH: the design of the study, the implementation of clinical treatment, article guidance and modification, statistical guidance and modification, Colposcopy diagnosis, Microendoscopy diagnosis; FL: the design of the study, the implementation of clinical treatment, article guidance and modification, statistical guidance and modification, Colposcopy diagnosis, Microendoscopy diagnosis.

Corresponding authors

Correspondence to Huiting Zhu or Zhiqiang Han or Fang Li.

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Conflict of interest

Junhan Guo, Le Fu, Junwei Zhao, Lei Lei, Qin Zhan, Min Liu,Yetian Ruan, Hui Li, Jin Xu, Huiting Zhu, Zhiqiang Han and Fang Li have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was approved by the the Ethics Committee of the Affiliated Hospital of Tongji University with protocol number KS1690, registered into the ClinicalTrials.gov registry with ID NCT02955667.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Guo, J., Fu, L., Zhao, J. et al. The value of microendoscopy in the diagnosis of cervical precancerous lesions and cervical microinvasive carcinoma. Arch Gynecol Obstet 302, 455–462 (2020). https://doi.org/10.1007/s00404-020-05565-8

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Keywords

  • Microendoscopy
  • Colposcopy
  • Cervical biopsy
  • Cervical precancerous lesions
  • Cervical microinvasive carcinoma