Colposcopic scoring system for biopsy decisions in different patient groups

Colposcopic scoring system have been used for distinguishing low-grade from high-grade cervical lesions. However. none of the previous studies have re ported colposcopic scoring systems for biopsy decisions in different patien t groups. The purpose of our study was to evaluate the safety of biopsy dec isions using the colposcopic score elaborated by Stellato and Paavonen (II) in 21 nonpregnant HIV infected patients (NP+) and 36 uninfected patients ( NP-), 12 HIV infected pregnant patients (P+) and 20 uninfected pregnant pat ients (P-) in the diagnosis of cervical intraepithelial neoplasias (CIN) an d HPV infection. The receiving operator curve was used for the establishmen t of a cut-off point in the scoring system graduation. The chi-square test was used for the statistical analysis. We obtained a safety cut-off value i n the colposcopic scoring system for each patient group. 4.5 for NP+; 4.0 f or NP- and 3.5 for P+ and P- patients. The sensitivity and specificity of t he colposcopic score for the detection of high-grade lesions for each group were respectively: 87.5 and 92.3% for NP+ patients; 90.9 and 92% for NP- p atients; 100 and 87.5% for P+ patients and 100 and 41.7% for P- patients. O ur results suggest that the colposcopic scoring system is a practical tool for a colposcopy-guided punch biopsy decision and detection of high-grade c ervical lesions in different patient groups. Further studies are needed to prove its clinical utility.