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Microcolposcopy vs. cone histology in evaluation of the endocervix in women with inadequate colposcopy or positive endocervical curettage.

Microcolposcopy (MC) can magnify cervical and endocervical surface cytology from 1:1 to 1:150. MC examination of the exocervix has been found to be equivalent to colposcopy. We compared MC to cone histology in evaluating the endocervix in women with inadequate colposcopy or positive endocervical curettage (ECC). Thirty-one patients were studied. All had standard colposcopic examinations that were deemed inadequate or resulted in positive ECC. MC was then performed and followed by cervical conization. Histologic specimens were obtained from serial sections of the surgical specimen. All 31 patients had adequate MC examinations. MC had a positive predictive value of 87% in evaluation of the endocervix as compared to cone histology specimens. Sensitivity and specificity were 99% and 70%, respectively. MC had a sensitivity of 92% in identifying the cervical segment with the worst histologic diagnosis. MC can evaluate the endocervix in patients with inadequate colposcopy or positive ECC. Biopsy of the worst histologic region in those patients can be guided by MC examination; thus, conization of the cervix can be avoided.