Resumo
Objective: To evaluate the diagnostic characteristics of fluorescence spectroscopy using LuViva technology for diagnosing cervical intraepithelial neoplasia.
Materials and methods: This study included 156 patients. The median patient age was 32 years (Q1–Q3: 27–39 years). All patients underwent fluorescence spectroscopy and cytological examination of the cervical and cervical canal scrapings using liquid cytology. Testing for high-risk human papillomavirus (hrHPV) using real-time PCR in cervical canal discharge was performed in 138 patients (88.5%), and extended colposcopy and targeted biopsy (as indicated) were performed in 52 women.
Results: The positive predictive value of fluorescence spectroscopy for detecting cytological changes of grade ≥ASCUS was 28.7% and the negative predictive value was 88.4%. The diagnostic characteristics of the methods used were compared with those of histological examination of cervical biopsy specimens. In the presence of hrHPV (43% of patients), the odds of detecting HSIL were almost 20 times higher (odds ratio [OR]=9.96, 95% CI 1.04–384.61). The sensitivity of the cytological test for LSIL and HSIL was 35.3% and 50%, respectively, whereas the specificity was 91.4% and 93.2%, respectively. The positive predictive values of cytological examination for LSIL and HSIL were 66.7% and 57.1%, respectively, while the negative predictive values were 74.4% and 91.1%, respectively. The positive predictive values of fluorescence spectroscopy for LSIL and HSIL were 42.5% and 15%, respectively, while the negative predictive values were 100% and 83.3%, respectively.
Conclusion: Fluorescence spectroscopy has higher sensitivity than liquid cytology. The non-invasive technique of fluorescence spectroscopy can act as a triage test for patients with conflicting results of cytology and HPV testing and determines the choice between immediate colposcopy and dynamic observation.