Folate receptor-mediated cervical staining as an adjunct to colposcopy which can improve the diagnostic accuracy of detecting high grade squamous intraepithelial lesions.

OBJECTIVES: Cervical cancer is rated fourth in terms of incidence and cancer-related mortality in women. Cytology-based screening programs and colposcopy provided insufficient rates of detecting cervical intraepithelial neoplasia (CIN) prompting researchers to develop new tools. The aim of this study was to evaluate whether folate receptor-mediated staining is useful in detecting CIN2+ during gynecological examination with colposcopy. MATERIAL AND METHODS: In total 96 women with abnormal cytology findings were enrolled. The study was conducted on the Polish population. The diagnostic process consisted of colposcopy, receptor-mediated diagnosis (FRD), and histopathology examination. All women were subjected to the same diagnostic procedure. RESULTS: The patient mean age of 96 women was 38 ± 14.5 years. On colposcopy, high-grade lesions were detected in 83 women. The FRD gave positive results in 63 women. Histopathology revealed 1 case of carcinoma plano epithelial akeratodes, 21 cases of high-grade squamous intraepithelial lesions, 13 cases of low-grade squamous intraepithelial lesions. A total of 61 cases presented no pathology. FRD as an adjunct to colposcopy gave the following test results in detecting CIN2+ lesions: sensitivity - 94.29%, specificity - 46.67%, PPV - 50.77%, NPV - 93.33%, and accuracy - 64.21%. Using both techniques provided better results than using each of the tests alone. CONCLUSIONS: FRD is a promising test for the diagnosing CIN2+ cervical pathologies because it can increase the probability of detecting CIN2+ without any additional burden posed on patients. Further studies should be conducted on large and various populations to complement current evidence.

Use of electrical impedance spectroscopy as an adjunct to colposcopy in a pathway of cervical intraepithelial neoplasia diagnostics.

OBJECTIVES: Screening with cytology decreases cervical cancer burden, but new methods have emerged. We assessed thediagnostic value of electrical impedance spectroscopy (EIS) in the real-world gynecological setting. The study aimed todetermine the diagnostic usefulness of EIS used as an adjunct to colposcopies in the diagnosis of high-grade squamousintraepithelial lesions in women with abnormal cytology findings. MATERIAL AND METHODS: A cross-sectional, single center, observational study considered 143 women. All were subjected toa colposcopy and EIS with ZedScan. ZedScan-guided or colposcopically-guided biopsies were carried out. RESULTS: Data from 118 women were analyzed. The average age of the included women was 38.29 } 12.52 years (range:22-86 years). Overall, 27 had a diagnosis of CIN2+ and above on histopathological examination, 99 had low-grade colposcopyresults, 18 had high-grade colposcopy results, and 80 had positive ZedScan examination. No adverse events relatedto the examination with ZedScan were observed. EIS used as an adjunct to colposcopies showed sensitivity of 96.30%(95% CI: 81.03-99.91) and specificity of 39.56% (95% CI: 29.46-50.36), and accuracy of 52.54% (95% CI: 43.15-61.81). Theprocedure allowed to detect 11 additional cases with positive histo-pathological result in comparison to colposcopies alone. CONCLUSIONS: Colposcopies performed with ZedScan as an adjunct were effective in detecting high-grade cervical lesions.Advantages of ZedScan include real-time result display, no additional diagnostic burden posed on the patient, andgood safety profile. Studies on large patient cohorts are needed for further evaluations of this diagnostic procedure andfactors which may affect its diagnostic accuracy.