Diagnostic Performance of TCT Combined with Colposcopy for Cervical Diseases

Objective The objectives of this study was to establish whether combined liquid-based thin-layer cells Detection System (TCT) with colposcopy inspection and the cervical biopsies taken with colposcopy improves the detection of cervical diseases. Methods A total of 756 outpatients who complained leukorrhagia, sexual intercourse bleeding and diagnosed cervical erosion after visual inspection at our hospital between January 2006 to December 2007 were analyzed retrospectively. All women underwent TCT examination, and 125 positive cases had colposcopy examination and biopsies. The accuracy of the combined test compared with TCT alone or colposcopy alone was evaluated using likelihood ratios. Results The accuracy of TCT is 83.10%. The estimated sensitivity, specificity, the positive likelihood ratios and the negative likelihood ratios were 86.44%(51/59), 88.10%(74/84), 83.61%(51/61) and 90.24%(74/82), respectively for TCT when used for diagnosis of CIN 1-3 lesions and cancer; and were 95.45%(63/66), 86.05%(74/86), 84.00%(63/75) and 96.10%(74/77), respectively for colposcopy examination. The coincidental rate of TCT compared with pathology is 83.1%, and is 71.43% compared with colposcopy examination. TCT examination diagnosed 2 patients with cervical cancer. One more patient was diagnosed cervical cancer when examined with colposcopy and pathological biopsy, which suggests that colposcopy has higher diagnostic performance than TCT. Conclusion TCT cell smear combined with histological biopsy taken by colposcopy can significantly increase the positive diagnosis rate of CIN lesions. This combined examination is considered as a safe, convenient, accurate and reliable method for the detection of cervical diseases. It can be used as screening method for CIN lesions.