Fluorescein colposcopy—A more specific diagnostic method for detection of high‐grade cervical precancer lesions than acetic acid
Abstract
Objective
To compare the sensitivity and specificity of topical fluorescein sodium (FNa) to acetic acid (AA) for the detection of high‐grade cervical lesions in colposcopy.
Materials and Methods
This prospective, cross‐sectional study was conducted between January and November 2017 at Christus Muguerza Hospital Conchita in Monterrey, Mexico. 78 women between 18 and 65 years age with a documented abnormal cervical smear test were included. Colposcopy by independent application of 5% AA and 0.06% topical FNa was performed and biopsy obtained for each woman.
Results
68 (87%) women tested positive with FNa, while 10 (13%) tested negative. Biopsy demonstrated high grade cervical lesions in 31 of the FNa positive but none of the FNa negative women. FNa staining demonstrated 100% sensitivity, 21% specificity, 46% positive predictive value (PPV), and 100% negative predictive value (NPV) to detect high‐grade lesions. In comparison, acetic acid staining demonstrated 100% sensitivity, 9% specificity, 42% PPV, and 100% NPV.
Conclusion
FNa had a 133% higher diagnostic specificity than AA (21% vs. 9%) for high‐grade lesions at a comparable cost and convenience. Visual inspection with FNa has the potential to replace visual inspection with AA in low‐resource settings, thus enabling true “diagnose and treat”.