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

摘要

Aim: 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 1059 cases referred for colposcopy at Peking University First Hospital were studied using both the R-way system and the conventional colposcopic method. Our study evaluated and compared the diagnostic ability of the two methods in detecting high-grade lesions and cervical cancer (hereinafter called CIN2+). Evaluating indicators including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Youden index and the area under the curve (AUC) of the receiver operating characteristic (ROC) were calculated. Results: The R-way system had a slightly lower specificity (94.52%) than conventional colposcopic method (95.99%) for CIN2+ detection (p = 0.181). However, the sensitivity (77.81%) was significantly higher than conventional colposcopic method (46.62%) (χ2 = 64.351, p < 0.001). Meanwhile, the AUC of the ROC for CIN2+ detection using R-way system (0.839) is larger than that with conventional colposcopic method (0.731) (Z = 4.348, p < 0.001). If preliminary results had been drawn from cervical exfoliated cytology before colposcopy referral, the combination of the R-way system with cytology could increase the sensitivity to 93.89% for CIN2+ detection (excluding ASCUSLSIL), which is confirmed by multiple punch biopsy or ECC. Conclusion: The diagnostic value of the R-way evaluation system is higher than that of the conventional colposcopic evaluation system in cervical cancer screening. Moreover, taking the ease of use and standardized quality control management into account, the R-way system is highly preferable.