Contribution of Cytology, Colposcopy, Target Biopsy and Conization to the Early Diagnosis of Precancerous and Cancerous Lesions of the Cervix Uteri

The study is based on. 334 cytologic suspect or positive women observed in the area of Florence. Cytologic diagnoses of dysplasia, carcinoma in situ (CIS), and invasive carcinoma are related to the histologic reports. To the same histologic reports are related the colposcopic aspects. Lastly, diagnoses made by target biopsy are compared with the final diagnoses made by cone biopsy. The 3 diagnostic methods and their diagnostic accuracy are then compared. As regards dysplasia, the diagnostic precision of cytology is 40.2% and for target biopsy is 76.9%. In the diagnosis of CIS, cytology shows a diagnostic accuracy (77.7%) that is a little lower than that of target biopsy (81.7%). In invasive carcinoma, cytology has a good diagnostic precision (88.2%), which becomes 100% if the diagnosis is made by target biopsy. The correlation between colposcopic aspects and histologic reports is not very reliable. We conclude that cytology is a valid test in an extensive mass screening, that colposcopy is essential to execute target biopsy, and that the latter is useful in defining dysplasia and invasive carcinoma diagnoses. On the contrary, in the case of CIS, target biopsy does not greatly increase cytology diagnostic precision.