[The value of computerized topographic evaluation for CIN changes in the cervix of young women based on effectiveness of CO2 laser therapy].

In: Ginekologia polska · 2000 · vol. 71(12) , pp. 1513–22 · PMID:11216169 · W2413293621
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Abstract

OBJECTIVES: Cervical cancer is one of the commonest neoplasms occurring in the female population of Poland. The discontinuance of radical treatment in CIN (Cervical Intraepithelial Noeplasia) cases for several years now is of particular importance for young women who are still in the reproductive age. DESIGN: The aim of the study was to evaluate early changes in the epithelium of the cervix by means of computer analysis of the fluorocolposcopic pattern. MATERIALS AND METHODS: The study included 164 young women (out of 2,098 women with cervical lesions) aged 18-35 years with a diagnostic of incipient CIN I-III changes in the cervix. The precise topography of the lesions was determined in fluorocolposcopy by the Berthalanffy technique using acridine orange. In the method the fluorocolposcopy made by "Polskie Zakłady Optyczne" was used. The analysis of the picture was made on the basis of a "MicroScan" programme. The florocolposcopic ones was transferred directly to the IBM Pentium II computer by means of a highly sensitive colour CCD OSCAR 35 camera. The image analysis was made simultaneously using a monochromatic camera CCD 6012P basing on a defined scale of greyness that corresponded to the luminescent of the method. The patients were treated exclusively with CO2 laser in the clinical reference centre. RESULTS: Of all the patients treated, a cure after one application of CO2 laser was achieved in 94.6%. 1 women with a pretreatment diagnosis of a CIN III lesions required further therapy. In all the 9 women (5.4%) requiring also further treatment, the degree of progression of the lesions was never greater than that found in the pretreatment evaluation. CONCLUSIONS: Extended colposcopic techniques (especially fluorocolposcopy) give a good insight into the biology of tissues involved in CIN processes. The introduction of computer analysis of fluorocolposcopic patterns permits precise determination of the topography of the lesions; especially to increased the efficacy of destructive treatment by CO2 laser. After the introduction of computer techniques in evaluation patterns of lesions, the efficacy of CO2 laser treatment of CIN lesions in young women is expected to rise to 99%.

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