caa a22 4500 605490783 CHVBK 20210128100506.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10147-014-0739-6 doi (NATIONALLICENCE)springer-10.1007/s10147-014-0739-6 Optimizing biopsy procedures during colposcopy for women with abnormal cervical cancer screening results: a multicenter prospective study [Elektronische Daten] [Yuko Nakamura, Koji Matsumoto, Toyomi Satoh, Ken Nishide, Akiko Nozue, Koji Shimabukuro, Seiichi Endo, Kimihiro Nagai, Akinori Oki, Takeo Minaguchi, Yukio Morishita, Masayuki Noguchi, Hiroyuki Yoshikawa] Background: In cervical cancer screening programs, women with abnormal cytology results are referred to colposcopy for histological diagnosis. This study was designed to evaluate the sensitivity of colposcopic procedures for detecting cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN). Methods: Women referred to colposcopy for abnormal cytology were enrolled from four hospitals. Gynecologists were required to take a colposcopy-guided biopsy from the worst of the abnormal-looking areas as a first biopsy. They were also asked to take ≥3 cervical specimens including by endocervical curettage (ECC). Random biopsies were performed at the gynecologist's discretion. We analyzed 827 biopsy results from 255 women who were diagnosed by central pathologists as having histology of CIN or cancer. Results: In this study, 78.1% of diagnoses of CIN grade 2 or worse (CIN2+) (the threshold that would trigger intensive management) were obtained from a first colposcopy-guided biopsy. The additional diagnostic utility of second and third colposcopy-guided biopsies was 16.4 and 1.8%, respectively. The combined sensitivity of two colposcopy-directed biopsies for CIN2+ detection was >90%, regardless of the colposcopist. Random biopsies and ECC increased the diagnostic yield of CIN2+ lesions otherwise missed by colposcopy-guided biopsies alone, but only by 1.2 and 2.4%, respectively. Random biopsies were more useful for women referred after low-grade abnormal cytology (P=0.01). The utility of ECC was greatest among women with unsatisfactory colposcopy (P=0.03) or aged ≥40years (P=0.02). Conclusions: Our data suggest that at least two colposcopy-directed biopsies should be taken for histological diagnosis. Random biopsies and ECC are recommended for special populations. Japan Society of Clinical Oncology, 2014 Colposcopy nationallicence Biopsy nationallicence CIN nationallicence Cervical cancer nationallicence Nakamura Yuko Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut Matsumoto Koji Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut Satoh Toyomi Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut Nishide Ken Department of Gynecology, Tsukuba Medical Center Hospital, 305-8558, Tsukuba, Japan aut Nozue Akiko Department of Gynecology, Tsukuba Medical Center Hospital, 305-8558, Tsukuba, Japan aut Shimabukuro Koji Department of Obstetrics and Gynecology, Tsuchiura Kyodo General Hospital, 300-0053, Tsuchiura, Japan aut Endo Seiichi Department of Obstetrics and Gynecology, Tsuchiura Kyodo General Hospital, 300-0053, Tsuchiura, Japan aut Nagai Kimihiro Department of Gynecology, Ibaraki Prefectural Central Hospital, 309-1793, Kasama, Japan aut Oki Akinori Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut Minaguchi Takeo Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut Morishita Yukio Department of Pathology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut Noguchi Masayuki Department of Pathology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut Yoshikawa Hiroyuki Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut International Journal of Clinical Oncology Springer Japan 20/3(2015-06-01), 579-585 1341-9625 20:3<579 2015 20 10147 https://doi.org/10.1007/s10147-014-0739-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10147-014-0739-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nakamura Yuko Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut NATIONALLICENCE 700 1- Matsumoto Koji Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut NATIONALLICENCE 700 1- Satoh Toyomi Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut NATIONALLICENCE 700 1- Nishide Ken Department of Gynecology, Tsukuba Medical Center Hospital, 305-8558, Tsukuba, Japan aut NATIONALLICENCE 700 1- Nozue Akiko Department of Gynecology, Tsukuba Medical Center Hospital, 305-8558, Tsukuba, Japan aut NATIONALLICENCE 700 1- Shimabukuro Koji Department of Obstetrics and Gynecology, Tsuchiura Kyodo General Hospital, 300-0053, Tsuchiura, Japan aut NATIONALLICENCE 700 1- Endo Seiichi Department of Obstetrics and Gynecology, Tsuchiura Kyodo General Hospital, 300-0053, Tsuchiura, Japan aut NATIONALLICENCE 700 1- Nagai Kimihiro Department of Gynecology, Ibaraki Prefectural Central Hospital, 309-1793, Kasama, Japan aut NATIONALLICENCE 700 1- Oki Akinori Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut NATIONALLICENCE 700 1- Minaguchi Takeo Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut NATIONALLICENCE 700 1- Morishita Yukio Department of Pathology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut NATIONALLICENCE 700 1- Noguchi Masayuki Department of Pathology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut NATIONALLICENCE 700 1- Yoshikawa Hiroyuki Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 305-8575, Tsukuba, Japan aut NATIONALLICENCE 773 0- International Journal of Clinical Oncology Springer Japan 20/3(2015-06-01), 579-585 1341-9625 20:3<579 2015 20 10147