EVALUATE THE ROLE OF ENDOCERVICOSCOPY AND CORRELATE THE ENDOCERVICAL FINDINGS WITH FINAL HISTOPATHOLOGICAL DIAGNOSIS

Abstract

Background: Cervical cancer is a major cause of deaths due to cancers among women worldwide. Screening of cancer cervix at an early stage not only decrease the mortality but also the morbidity among women of developing countries. Various methods have been tried to visualize the entire TZ which include the use of endocervical speculum, osmotic dilators including laminaria and lamicel, use of ethinyl estradiol, and misoprostol. However, these techniques have a limited success rate and in around 30-40% cases TZ cannot be visualised completely. Methodology- The study was carried out in the Department of Obstetrics and Gynaecology and Department of Pathology at a tertiary care hospital from December 2013 to April 2015.40 patients fulfilling the inclusion and exclusion criteria were included in the study. After taking an informed written consent from all the subjects, a complete medical and gynaecological examination was performed and baseline data was recorded and endocervicoscopy was performed. Data was analyzed and entered into Microsoft excel sheet.
Result- On colposcopic examination, all patients had adequate colposcopy with T3 TZ i.e. upper margin of TZ was inside the endocervical canal. Of the 40 patients, SCJ was partially visible in 22 patients (55%) and completely invisible in 18 patients (45%). Colposcopy findings of the visible TZ on ectocervix were normal in 2 patients (5%). Remaining 38 patients (95%) had abnormal findings out of which 30 patients had grade 1 lesion, 7 patients had grade 2 lesions and 1 patient had non-specific changes. The above study visualize the complete SCJ in all the cases. Conclusion- Endocervicosopy was found to be 100%  successful in visualization of the SCJ in all the cases. The positive predictive value (PPV) of endocervicoscopy in our study was 33.3% and negative predictive value (NPV) was 100%. The use of endocervicoscopy in cases of T3 TZ on colposcopy is recommended.