Optimization of the Neck of the Uterus Neoplasia Diagnosis Using Optical Coherent Tomography
The aim of the study is to substantiate the use expediency of the new algorithm of the neck of the uterus neoplasia diagnosis and to evaluate the approach effectiveness. An optical coherent tomography (OCT) has been used in this research.
Materials and Methods. 380 patients with all the spectrum of the neck of the uterus states have been examined. Under the investigation there have been cytological investigation, and a HPV-test, a colposcopic examination, an OCT, a morphological investigation.
Results. An OCT is capable of visualizing the neck of the uterus mucous membrane at the layers level and intratissue elements. A method sensibility in recognition of a mucous membrane neoplasia is 82%, a specificity is 78%, the errors — 19.2% (k=0.65). An OCT-investigation is compatible with colposcopy in real clinical conditions. It is capable of differentiating the colposcopic signs according to a possible malignization risk based on optical picture types. An OCT as a diagnostic algorithm allows to reveal the neck of the uterus pathology and to decrease the biopsy volume by 34%.
Conclusion. A complementary use of colposcopy and OCT makes it possible to avoid not only random biopsies, but significantly decrease a number of wrong manipulations (more than by 30%).
An OCT method is certain to be included into the algorithm of the neck of the uterus examination at a stage of the indication detection and a biopsy site selection carrying out colposcopic investigation. This is sure to increase effectiveness of the precancer and cancer early diagnosis.
