Cervico-vaginal cytology and condylomata. Reproducibility and predictive value]

Human Papilloma Virus (HPV) is associated with two groups of intra-epithelial lesions of the cervix: the condyloma or the very low grade lesion, and intra-epithelial cervical neoplasia (CIN) or a higher grade of lesion. Cervico-vaginal cytology can be used to screen for these two types of lesion. Further to this research is to evaluate the reproducibility and the predicted value of cervico-vaginal cytology to detect condylomas. The study is based on 610 patients who were referred because of abnormal cytology. 270 (44%) of these patients were referred because the cytology suggested condylomas and 241 (40%) had cytological signs of CIN. The reference cytology and the control cytology did not accord well. Control cytology showed signs of condyloma in only 116 (43%) of the 270 patients referred for this type of lesion. On the other hand in the case of CIN there was better correlation. Of the 241 patients who were referred for cytological signs of CIN 185 (70%) also had these signs on controlled cytology. The positive predictive value of cytology to diagnose condyloma is relatively poor. In only 126 (47%) of the women referred with diagnosis of condyloma could this diagnosis be confirmed histologically, 20% of these 270 patients had CIN. In contrast the positive predictive value of cytology with signs of CIN were better-182 (76%) of 241 patients who were referred with CIN had the diagnosis confirmed histologically.