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Colposcopy and Its Role in the Early Detection of Cervix Precancerous Lesions

تنظير عنق الرحم المكبر و دوره في الكشف المبكر عن الآفات ما قبل السرطانية في عنق الرحم

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 Publication date 2010
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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Cervix cancer is one of the most important gynecological cancers ,which is possible to be reduced by using early precancerous detecting technics . Objective : The aim of the study is to highlighten the colposcopy as a device for early detection of precancerous lesions in the cervix , and compare the results with histopathology .


Artificial intelligence review:
Research summary
تتناول هذه الدراسة دور تنظير عنق الرحم المكبر في الكشف المبكر عن الآفات ما قبل السرطانية في عنق الرحم. تم إجراء البحث في مشفى التوليد الجامعي بدمشق بين فبراير 2008 ويونيو 2009، وشملت الدراسة 142 مريضة. أظهرت النتائج أن نسبة البشرة الشاذة باستخدام منظار عنق الرحم كانت 50%، وأن 52.8% من المريضات يحتجن إلى متابعة جدية بإجراء دراسة نسيجية. كانت حساسية الفحص 97.72% ونوعيته 31.71%. خلصت الدراسة إلى أن تنظير عنق الرحم المكبر يعد وسيلة مثالية لتحديد شكل الآفة وأخذ الخزعات الموجهة لكشف التظاهرات الباكرة للآفات ما قبل السرطانية. كما أكدت الدراسة على أهمية كفاية التنظير ورؤية المنطقة الانتقالية للوصول إلى تشخيص صحيح، وضرورة تدريب الكوادر الطبية على قراءة صحيحة للموجودات التنظيرية وتوفير أتمتة وأرشفة لبيانات المرضى ونتائج التنظير والخزعات.
Critical review
دراسة نقدية: تعد هذه الدراسة خطوة هامة في مجال الكشف المبكر عن سرطان عنق الرحم باستخدام تنظير عنق الرحم المكبر. ومع ذلك، يمكن الإشارة إلى بعض النقاط التي قد تحتاج إلى تحسين. أولاً، نسبة النوعية المنخفضة (31.71%) تشير إلى وجود نسبة عالية من الإيجابيات الكاذبة، مما قد يؤدي إلى إجراءات طبية غير ضرورية وزيادة القلق لدى المريضات. ثانياً، الدراسة لم تتناول بشكل كافٍ تأثير العوامل الاجتماعية والاقتصادية على نتائج الفحص، وهو جانب مهم يجب أخذه في الاعتبار. ثالثاً، كان من الممكن تحسين الدراسة بزيادة حجم العينة وتنوعها لتشمل مناطق جغرافية مختلفة، مما يعزز من تعميم النتائج. وأخيراً، يجب التركيز على تدريب الكوادر الطبية بشكل مستمر لضمان دقة التشخيص وتقليل نسبة الأخطاء.
Questions related to the research
  1. ما هي نسبة حساسية الفحص باستخدام تنظير عنق الرحم المكبر في هذه الدراسة؟

    نسبة حساسية الفحص كانت 97.72%.

  2. كم عدد المريضات اللواتي شملتهن الدراسة؟

    شملت الدراسة 142 مريضة.

  3. ما هي نسبة المريضات اللواتي يحتجن إلى متابعة جدية بإجراء دراسة نسيجية؟

    52.8% من المريضات يحتجن إلى متابعة جدية بإجراء دراسة نسيجية.

  4. ما هي نسبة النوعية للفحص باستخدام تنظير عنق الرحم المكبر؟

    نسبة النوعية كانت 31.71%.


References used
WHO/ICO Information Centre on HPV and Cervical Cancer. HPV and cervical cancer in the world: 2007 report. Vaccine 2007;25:Suppl 3:C1-C230
Michael J. Thun, John Oliver DeLancey, Melissa M. Center, Ahmedin Jemal, and Elizabeth M. Ward .The global burden of cancer: priorities for prevention . Carcinogenesis. 2010 January; 31(1): 100–110
carcinoma of the cervix and Tobacco smoking : Collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies. Int J Cancer 2006 ;118:1481
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Mankind is still suffering from many diseases , and with the development of civilization there are many diseases that appear with different clinical types , but tumors, especially malignant , are still very important. Cervical cancer is the secon d common cancer in women , as it is the cause of more than 200.000 deaths annually. Hence the importance of early detection of cervical cancer and of decreasing mortality.
This research was carried out in the Department of Obstetrics and Gynecology in Alassad Hospital of Tishreen University in Lattakia in the period between 5th of Jan 2012 to 1st of Aug 2013. The sample tested was divided into two groups: 100 pregnant women, and 50 not pregnant. The study showed that the ratio of the sensitivity of Pap test in pregnancy was 100%, and its quality was 76.74%. The Compatibility with overall histological diagnosis was 79.38%. However, the ratio of the sensitivity of Colposcopy was 90.91% and its quality was 76.74%. The Compatibility with overall histological diagnosis was 78.35%. Thus we conclude that both Pap Smear and colposcopy are safe and good scanning tools. They can be used in the preliminary prognosis for carcinomatous and precarcinomatous tumors through the duration of pregnancy.
The research was conducted in the department of obstetrics and gynecology at Al-Assad university hospital in Lattakia in the period between (1/1/2014) – (30/6/2015). The study included (100) patient, who submitted to colposcopy and Papanicolaou smear to detect the effect of early marriage (early onset of sexual activity) on colposcopic and cellular finding in cervix . The results in (early married women) group (50) patient were compared to control group from patients who (not early married women)group (50) patient. We found that there was important difference in the rate of abnormal colposcopic findings : This rate in early married women was (26%) and in the second was (12%). We also found that there was important difference in the rate of abnormal cellular findings: This rate in early married women was (18%) and in the second was (8%). This assure the effect of early onset of sexual activity (early marriage) on colposcopical and cellular finding in cervix with assuring on the importance of frequent colposcopy and Papanicolaou smear test.
As the prevalence of obesity has been increasing rapidly worldwide in recent times where became of the most important diseases of age and the most influential public health, where a second reason stainless prevention after smoking and leading to de adly diseases, where it proved its relationship with many cancers, especially cancers women such as cancer of the endometrine of the uterus and breast cancer, where one study showed that obesity increases the progression of a range of cancers also increase the proportion of morbidity and mortality resulting scientifically it is useful to highlight the impact of obesity on the cellular changes and cervical colposcopy. Research aim and justifications:To draw attention to the importance of obesity as a potential factor to cause cellular alterations in the cervix due to it being a factor can be prevented and thus emphasize the need to include obese within the league scanning programs. The absence of a similar earlier study in Assad University Hospital. Research methods and materials:Study 100 included sick of reviews the department of obstetrics and gynecology at the Assad University Hospital in Lattakia during the period between 01/01/2012 and 01/01/2014, where they were questioning the patients and record information on Bmhar body mass (weight, height) and did not study included patients smokers or users of oral contraceptives or devices within the uterus (IUDs) or pregnant women or women with frequent infections. Results : - The existence of consensus between the results of endoscopic magnifier of the cervix and cytological tests observed any that theory has not ignored any abnormal condition, with some cases of false positive and this goes back to that colposcopy is a diagnostic test depends on the evaluation of endoscopy specialist and his expertise in the interpretation of laparoscopic assets. - Also found consensus among the results of smear and cellular screening with the presence also some cases of false positive and this is due to not taking the biopsy directed properly, as is the smear relatively test depends on the estimation of anatomy specialist patients and the presence of abnormalities cell or to the extent this anomaly or for the possibility of error contained in the way sampling or sample installed. Conclusion:It turns out the study and depending on the value of the P value of a relationship between obesity and assets laparoscopic and cellular cervix and thus conclude that all of Stain and theorizing magnifier of the cervix and Sillete survey competently and are necessary can rely on them in the initial survey for cancerous lesions and pre-cancer of the cervix in women obese.

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