A colposcopic scoring system for grading cervical lesions.

Colposcopic scoring systems have been used for distinguishing low-risk from high-risk cervical lesions. We studied 159 HPV DNA positive patients (7 with HPV 6/11, 51 with HPV 16/18, 52 with HPV31/33/35, 25 with mixed HPV types, and 24 with untypable HPV) (mean age 25.7 years, SD 7.4), and 69 age matched HPV-DNA negative control, patients, drawn from the same clinical setting. A dot-blot hybridization technique (ViraPap and VyraType, Digene Diagnostics, MD, USA) was used for HPV DNA hybridizations types 6/11, 16/18, and 31/33/35. Each patient underwent cytologic and colposcopic evaluation at four-month intervals. A colposcopic score for grading cervical lesions was used. It included features of lesion borders, tone of acetowhitening, and vascular atypia. Each feature was graded using three categories, so that an increasing score would be associated with gradually more severe lesions. The mean follow-up time was 12.2 months (SD 8.7) for the cases, and 12.8 months (SD 6.9) for the controls. The study end point was defined as the presence of cytologic changes consistent with CIN, in which case colposcopically directed biopsy and endocervical curettage were performed. The mean colposcopic score derived from the features of ATZ was 4.9 in the HPV DNA positive patients and 4.3 in the HPV DNA negative patients. The mean colposcopic score was 3.3 for those with HPV 6/11, 4.5 for HPV 16/18, 5.3 for HPV 31/33/35, 5.0 for mixed HPV types, and 4.0 for untypable HPV.(ABSTRACT TRUNCATED AT 250 WORDS)