Research Article| Volume 130, ISSUE 6, P692-699, December 2020

Diagnostic accuracy of colposcopic examination in patients with oral dysplastic lesions

Published:September 24, 2020DOI:


      Colposcopy is a direct microscopic method and is the gold standard tool to detect early cervical dysplastic lesions. In the past, many attempts have been made to use gynecologic methods to examine the oral mucosa. The aim of this study was to detect the diagnostic accuracy of oral colposcopy in diagnosing oral dysplastic lesions in comparison with microscopic evaluation based on biopsy and compare Reid's Colposcopic Index (RCI) and the Swede scoring system in diagnosing oral dysplastic lesions.

      Study Design

      Twenty-five patients who presented for diagnosis of oral leukoplakia to the Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University (Cairo, Egypt) and met the selection criteria were recruited in this study. Each patient was subjected to colposcopic examination, followed by biopsy to confirm the results of colposcopy. The sensitivity and specificity of oral colposcopy were calculated after colposcopic assessment by using the Swede scoring system and the RCI.


      The diagnostic accuracy of oral colposcopy with use of the Swede scoring system was superior to that of oral colposcopy with the use of the RCI.


      Colposcopic examination using the Swede scoring system is very specific for diagnosing oral epithelial dysplasia and for using the “see-and-treat” method, whereas the RCI is a very sensitive screening method for the diagnosis of oral epithelial dysplasia in oral potentially malignant disorders.
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        • El-Naggar AK
        • Chan JKC
        • Grandis JR
        • Takata T
        • Slootweg PJ
        WHO Classification of Head and Neck Tumours.
        4th ed. IARC, IARC. Lyon, France2017: 112-113
        • Nayyar A
        • Khan M
        • Bafna U
        • Ahmed S
        • Chaluvaiah G
        Colposcopy in oral epithelial dysplasia: seeing the unseen, a pilot study.
        J Cancer Res Ther. 2014; 10: 563
        • Ohri N
        • Kapoor C
        • Mohemmed RP
        • Vaidya S
        An update on intraoral application of colposcopy.
        J Oral Maxillofac Pathol. 2014; 18: 403
        • ‏ Pallagatti S
        • Sheikh S
        • Puri N
        • Gupta D
        • Singh B
        Colposcopy: a new ray in the diagnosis of oral lesions.
        Indian J Dent Res. 2011; 22: 810
        • Liu D
        • Zhao X
        • Zeng X
        • Dan H
        • Chen Q
        Non-invasive techniques for detection and diagnosis of oral potentially malignant disorders.
        Tohoku J Exp Med. 2016; 238: 165-177
        • Ujwala N
        • Singh NA
        • Milind N
        • et al.
        Colposcopy in pre-malignant lesions and oral squamous cell carcinoma: linking threads of clinical, histopathological and colposcopic inferences.
        J Cancer Res Cell Ther. 2016; 12: 295
        • Khan MJ
        • Werner CL
        • Darragh TM
        • et al.
        ASCCP colposcopy standards: role of colposcopy, benefits, potential harms, and terminology for colposcopic practice.
        J Low Genit Tract Dis. 2017; 21: 223-229
        • Strander B
        • Ellström-Andersson A
        • Franzén S
        • Milsom I
        • Rådberg T
        The performance of a new scoring system for colposcopy in detecting high-grade dysplasia in the uterine cervix.
        Acta Obstet Gynecol Scand. 2005; 84: 1013-1017
        • Bossuyt PM
        • Reitsma JB
        • Bruns DE
        • et al.
        STARD 2015-An updated list of essential items for reporting diagnostic accuracy studies.
        BMJ. 2015; (351h5527)
        • Kumar A
        • Shankar YU
        • Prakash S
        • Radhika B
        • Fatima N
        Colposcopy—a novel diagnostic technique for oral mucosal lesions.
        J Clin Diagn Res. 2014; 8: 25
        • Bowring J
        • Strander B
        • Young M
        • Evans H
        • Walker P
        The Swede score: evaluation of a scoring system designed to improve the predictive value of colposcopy.
        J Low Genit Tract Dis. 2010; 14: 301-305
        • Kushwah S
        • Kushwah B.
        Correlation of two colposcopic indices for predicting premalignant lesions of cervix.
        J Midlife Health. 2017; 8: 118
        • Shojaei H
        • Yarandi F
        • Ghozati L
        • Yarandi N
        • Izadi-Mood N
        • Eftekhar Z
        Acceptable predictive accuracy of histopathology results by colposcopy done by gynecology residents using Reid index.
        Arch Gynecol Obstet. 2013; 287: 345-349
        • Mahmoud SAM
        • Abdul-Latif MK
        • Dahmoush HM
        • Hussein EA
        Methodology and raw data of the diagnostic accuracy of oral colposcopy.
        Mendeley Data. 2020; (Available at: fhj?submission_id=OO_77782&token=78 ea1334-dcc0-4490-ad73-58 f4711 d3 bb1)
        • Kashyap B
        • Pallavi N
        • Shruthi BS
        • Birajdar S
        Evaluation of oral epithelial dysplastic features in oral lichen planus: the diagnostic difficulties.
        Clin Cancer Investig J. 2015; 4: 327
        • Bandyopadhyay A
        • Behura SS
        • Nishat R
        • Dash KC
        • Bhuyan L
        • Ramachandra S
        Clinicopathological profile and malignant transformation in oral lichen planus: a retrospective study.
        J Int Soc Prev Community Dent. 2017; 7: 116
        • Mostafa B
        • Ahmed E.
        Prevalence of oral lichen planus among a sample of the Egyptian population.
        J Clin Exp Dent. 2015; 7: 7
        • Irani S
        • Esfahani AM
        • Ghorbani A
        Dysplastic change rate in cases of oral lichen planus: a retrospective study of 112 cases in an Iranian population.
        J Oral Maxillofac Pathol. 2016; 20: 395
        • Sehgal VN
        • Syed NH
        • Aggarwal A
        • Sehgal S
        Oral lichen planus: a cross-sectional/descriptive study of 33 patients.
        Skinmed. 2017; 15: 333-337
        • Mishra M
        • Mohanty J
        • Sengupta S
        • Tripathy S
        Epidemiological and clinicopathological study of oral leukoplakia.
        Indian J Dermatol. 2005; 71: 161
        • Gopinath D
        • Thannikunnath BV
        • Neermunda SF
        Prevalence of carcinomatous foci in oral leukoplakia: a clinicopathologic study of 546 Indian samples.
        J Clin Diagn Res. 2016; 10: 78
        • Ranga R
        • Rai S
        • Kumari A
        • et al.
        A comparison of the strength of association of Reid Colposcopic index and swede score with cervical histology.
        J Low Genit Tract Dis. 2017; 21: 55-58
        • Durdi GS
        • Sherigar BY
        • Dalal AM
        • Desai BR
        • Malur PR
        Correlation of colposcopy using Reid colposcopic index with histopathology—a prospective study.
        J Turk Ger Gynecol Assoc. 2009; 10: 205
        • Eftekhar Z
        • Rahimi-Moghaddam P
        • Yarandi F
        • Brojerdi R
        Accuracy of visual inspection with acetic acid (VIA) for early detection of cervical dysplasia in Tehran, Iran.
        Asian Pac J Cancer Prev. 2005; 6: 69-71
        • Huchko MJ
        • Sneden J
        • Zakaras JM
        • et al.
        A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to visual inspection with Lugol's iodine for cervical cancer screening in HIV-infected women.
        PLoS One. 2015; 10 (e0118568)
        • Vedantham H
        • Silver MI
        • Kalpana B
        • et al.
        Determinants of VIA (visual inspection of the cervix after acetic acid application) positivity in cervical cancer screening of women in a peri-urban area in Andhra Pradesh, India.
        Cancer Epidemiol Biomarkers Prev. 2010; 19: 1373-1380
        • Koch S
        • Nusrat A.
        The life and death of epithelia during inflammation: lessons learned from the gut.
        Annu Rev Pathol. 2012; 7: 35-60
        • Carrard VC
        • Van der Waal I
        A clinical diagnosis of oral leukoplakia: a guide for dentists.
        Med Oral Patol Oral Cir Bucal. 2018; 23: 59
        • Al‐Hassiny A
        • Friedlander LT
        • B. Parachuru VP
        • Seo N
        • Hussaini HM
        • Rich AM
        Upregulation of angiogenesis in oral lichen planus.
        J Oral Pathol Med. 2018; 47: 173-178
        • Alim MA
        • Rahman QB
        • Hossain S
        Use of Lugol's iodine solution in screening of oral premalignant and malignant lesions.
        Int J Dent Med. 2015; 1: 8