Abstract

BARRIOS-GARCIA, Lía  and  CONTRERAS-BORREGO, Eusebio Enrique. Diagnostic agreement for cytology, curettage and biopsy regarding surgical resection specimen histopathological study of premalignant cervical lesions in postmenopausal patients attending the Clínica "Maternidad Rafael Calvo" in Cartagena, Colombia, 2007-2011. Rev Colomb Obstet Ginecol [online]. 2012, vol.63, n.2, pp.134-139. ISSN 0034-7434.

Objective: Determining diagnostic agreement concerning cytology, endocervical curettage and biopsy for premalignant cervical lesions in postmenopausal patients, regarding surgical resection specimen histopathological study. Materials and methods: This was a diagnostic agreement conformity study which was carried out from 2007 to 2011. The Clínica "Maternidad Rafael Calvo" pathology service's database was used; this is a reference entity in gynaecological surgery, cervical pathology and Colposcopy for Cartagena's (Colombia) low socioeconomic population covered by the subsidized health insurance regime. All reports concerning histopathological studies concerning conization or hysterectomy were selected for patients older than 56 years which documented a cytological and/or histological preoperative diagnosis of premalignant lesions as surgical motive for evaluating their degree of agreement using a Kappa coefficient Positive predictive value (PPV) was estimated. Results: 75 cases were studied, having an average age of 63 years (57-77 range); such cases concerned surgical resection studies dealing with 41 conizations and 34 hysterectomies. There was 39% premalignant or malignant lesion prevalence in resection specimen histopathological study. Diagnostic agreement for premalignant cervical lesions in postmenopausal patients, regarding surgical resection specimen histopathological study was: 0.056 endocervical curettage and 0.090 biopsy; for cytology was not estimable; PPV ranged from 0% to 52.6%. Conclusion: Surgical resection specimen histopathological study agreement with premalignant cervical lesions diagnosis in postmenopausal patients was slight for histological studies (biopsy and endocervical curettage, being better in biopsy). Such studies’ PPV was better for high-grade lesions compared to low-grade ones.

Keywords : Postmenopausal; conization; hysterectomy; cervical intraepithelial neoplasia; diagnostic agreement.

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