OBJECTIVE. Because high-risk human papillomavirus (hrHPV) is the necessary factor in the development of high-grade cervical lesions, knowing the colposcopic differences between hrHPV-positive and hrHPV-negative lesions could be of value. We have evaluated whether there are colposcopic differences between lesions testing hrHPV-positive or hrHPV-negative. MATERIALS AND METHODS. This study was conducted as a retrospective case-control study. We designed a scoring system for colposcopic criteria that might be of relevance to distinguish hrHPV-positive from hrHPV-negative lesions. Colposcopic images were analyzed from patients at the VU University Medical Center Amsterdam, the Netherlands, in whom a GP5+/6+ polymerase chain reaction hrHPV test had been performed within a month of the colposcopic examination (n = 507). RESULTS. Visibility of the transformation zone (corrected for age), a (very) coarse and irregular punctation pattern, and a large lesion (>25% of the visible cervix) were more often associated with a positive hrHPV test status (p =.001, odds ratio [OR] = 2.29, 95% CI = 1.41-3.73; p =.036, OR 2.37, 95% CI = 1.08-5.19; and p =.044, OR = 1.78, 95% CI = 1.08-2.94, respectively). After correction for histologic diagnosis, the difference between hrHPV-positive and hrHPV-negative lesions for visibility of the transformation zone and lesion size remained statistically significant (OR = 2.44, 95% CI = 1.35-4.41 and OR = 1.92, 95% CI = 1.04-3.54, respectively). CONCLUSIONS.: This study indicates that visibility of the transformation zone, (very) coarse punctation pattern, and larger lesion size were the main colposcopic features associated with a hrHPV-positive test status.

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doi.org/10.1097/LGT.0b013e3181b0fb8e, hdl.handle.net/1765/28337
Journal of Lower Genital Tract Disease
Erasmus MC: University Medical Center Rotterdam

Louwers, J.A, Kocken, M, van der Bijl, J.C, Berkhof, J, Snijders, P.J.F, Meijer, C.J.L.M, & Verheijen, R.H.M. (2010). Colposcopic characteristics of high-risk human papillomavirus-related cervical lesions. Journal of Lower Genital Tract Disease, 14(1), 49–55. doi:10.1097/LGT.0b013e3181b0fb8e