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| Efficacy of Colposcopic Cervical Biopsy in Diagnosing Cervical Precancerous Lesions and Risk Factors for Missed Diagnosis of Cervical Cancer |
| XIA Li, ZHANG Hongxia, YU Min, et al |
| 901st Hospital of the Chinese People's Liberation Army Joint Logistic Support Force, Anhui Hefei 230031, China |
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Abstract Objective: To evaluate the efficacy of colposcopic cervical biopsy in diagnosing cervical precancerous lesions and to identify risk factors for missed diagnosis of cervical cancer (CC). Methods: A retrospective analysis was conducted on 119 patients diagnosed with cervical precancerous lesions by colposcopic cervical biopsy at our hospital from April 2020 to April 2023. The pathological results of loop electrosurgical excision procedure (LEEP) were used as the gold standard. Kappa consistency testing was performed to assess the diagnostic accuracy of colposcopic cervical biopsy. The rate of missed CC diagnoses was calculated, and risk factors for missed diagnosis were analyzed. Results: The kappa value between colposcopic cervical biopsy and pathological examination was 0.439, indicating moderate agreement with the gold standard. Among the 119 patients, 18 cases of CC were missed, resulting in a missed diagnosis rate of 15.13%. Univariate analysis showed that patients aged ≥55 years, with cervical lesion area <1/2, no cervical curettage, unsatisfactory colposcopy images, and a single biopsy specimen had significantly higher missed diagnosis rates compared to those aged <55 years, with cervical lesion area ≥1/2, cervical curettage, satisfactory colposcopy images, and ≥2 biopsy specimens (P<0.05). Logistic regression analysis identified age ≥55 years (OR=1.547, 95%CI: 1.180~2.027), cervical lesion area <1/2 (OR=1.451, 95%CI: 1.133~1.857), no cervical curettage (OR=1.988, 95%CI: 1.304~3.030), unsatisfactory colposcopy images (OR=2.782, 95%CI: 1.793~4.315), and a single biopsy specimen (OR=1.093, 95%CI: 1.015~1.178) as significant risk factors for missed CC diagnosis. Conclusion: Colposcopic cervical biopsy demonstrates moderate accuracy in diagnosing cervical precancerous lesions but carries a notable risk of missed CC diagnosis. Risk factors include advanced age, smaller lesion area, lack of cervical curettage, poor colposcopy image quality, and insufficient biopsy specimens. Clinicians should prioritize elderly patients, improve imaging quality, and perform multi-point biopsies to reduce the risk of missed CC diagnoses.
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2025, Vol. 31 
