Evaluation Of The Accuracy Of Modified Reid Score In Colposcopic Cervical Assessment

Abstract

ln this work we evaluated patients with abnormal Papanicolaou smear by visual colposcopy, scoring system using Reid 's col poscopic index and histopathology.

This study included a group of 50-non pregnant women with an abnormal Pap smears. For every patient full history was taken, local exan1inati.on especiall y inspection of the cervix, visual col poscopy, Reid 's [ndex, and guided punch biopsy from suspicious area for histopathologic examination.

Visual col poscopy detected 27 cases with sub clinical human papilloma virus, 21 cases with mi l d dysplasia (CTN I ) and 2 cases with sever dysplasia (CTN Ill).

Col poscopic index detected: -

• Forty-two cases scoring 0-2 poi nts [benign papilloma viral infection or mi ld d yspl asia].

• Four cases scoring 3-4 points [either mild or moderate dyspl asia].

• Four cases scoring 5-8 points [cervical intraepithelial neoplasia grade-IT or grade-III].

As regards the histopathologic study: -

• N ineteen cases were Human Papilloma Virus.

• Twenty-seven cases were CIN1.

• Two cases were CINll.

• Two cases were CTN ll f.

The predicti ve accuracy of the vis ual colposcopy compared to the histopathologic result was 66%, versus 96% when using the scoring system.

So al though it is well known that Colposcopy has an important place in evaluation of the patients with abnormal smear but Scoring system improves the accuracy of the colposcopi c diagnosis and it has the greatest advantage of the sea and treat approach wruch is the abili ty to manage patients in a singl e office visit, eliminating the danger that they may not return for treatment and spares them the anxiety of waiting for biopsy results.

Lastly, but not the least, Colposcopically guided Biopsy may cl ari fy inconclusive Cytol ogic findings and point to the abnormal location and extent of the lesion to be diagnosed by histopathology.