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Indications and limitations of colposcopy

Released on Jun. 28, 2021

The colposcopy observes the vulva, vagina and cervical epithelial structure and blood vessels to find out the abnormal epithelium and abnormal blood vessels related to cancer, until the biopsy of suspicious lesions, to assist in the diagnosis of cervical intraepithelial neoplasia (CIN) and early cervical cancer And other inspection methods.

Indications of colposcopy

1. There are abnormal clinical symptoms and signs. Such as abnormal increase in vaginal secretions treatment is ineffective, contact bleeding, cervicitis does not heal for a long time, etc.

2. Clinically suspicious lesions: a suspicious lesion or undiagnosed new organisms are found by visual inspection on the clinical bed.

3. Suspicious pathological sections: When pathological sections are suspicious, biopsy under colposcopy can improve the correct rate of pathological diagnosis.

4. Clinical and pathological discrepancies: When the clinical diagnosis is inconsistent with the pathological diagnosis, the correct diagnosis can be made with the help of colposcopy.

5. Patients with cervical precancerous disease and suspicious cervical cancer.

6. Suspicious cervical metastases.

7. Abnormal vaginal cytology: Pap smears are level two or more than one hundred.

8. Vaginal lesions: such as vaginal neoplasms, nodules, etc. of unknown nature, suspected vaginal adenopathy, vaginal malignant tumors, etc.

9. Diagnosis of vulvar lesions: vulvar itching, specific vulvar pigment changes, and unknown nature of vulvar vegetation.

10. Diagnosis of condyloma acuminatum: especially the diagnosis of subclinical lesions.

11. Follow-up: The treatment of cervicitis, cervical precancerous lesions, condyloma acuminatum, vaginal lesions, vulvar disease, etc. can be evaluated by colposcopy to evaluate the treatment effect and observe the development of the disease.

Limitations of colposcopy:

(1) Colposcopy cannot observe the lesions in the cervical canal, especially in postmenopausal women or treated cervix, the squamous column junction moves up to the neck, or the lesion extends into the cervical canal beyond the colposcopy field of view, which can cause false negatives (about 10%) );

(2) The colposcopy cannot determine the presence or absence of interstitial infiltration, which affects the judgment of the colposcopy when the epithelial defect or matrix is exposed;

(3) The interpretation of colposcopy images is subjective, which affects the selection and diagnosis of biopsy sites;