Performance of the R-way Colposcopic Evaluation System in Cervical Cancer Screening

摘要

Objective: To investigate the diagnostic value of the R-way colposcopic evaluation system (R-way system)in cervical cancer screening. Materials and Methods: Between August 2013 and August 2014, a total of 1,059cases referred to colposcopy in Peking University First Hospital were studied using both the R-way system andconventional colposcopy. Our study evaluated and compared the diagnostic ability of the two methods in detectinghigh-grade lesions and cervical cancer (hereinafter called CIN2+). Evaluation indicators including sensitivity,specificity, positive predictive value (PPV), negative predictive value (NPV), Youden index and the area underthe curve (AUC) of the receiver operating characteristic (ROC) were calculated. Results: The R-way systemhad a slightly lower specificity (94.5%) than conventional colposcopy (96.0%) for CIN2+ detection (P=0.181).However, the sensitivity (77.8%) was significantly higher than with the conventional colposcopic method (46.6%)(χ2=64.351, P<0.001). In addition, the AUC of the ROC for CIN2+ detection using the R-way system (0.839) waslarger than that with conventional colposcopy (0.731) (Z=4.348, P<0.001). If preliminary result had been drawnfrom cervical exfoliated cytology before colposcopy referral, combination of the R-way system with cytology couldincrease the sensitivity to 93.9% for CIN2+ detection (excluding ASCUSLSIL), confirmed by multipoint biopsyor ECC. Conclusions: The diagnostic value of the R-way evaluation system is higher than that of conventionalcolposcopic evaluation in cervical cancer screening. Moreover, taking the ease of use and standardized qualitycontrol management into account, the R-way system is highly preferable.