Folate receptor-mediated cervical staining as an adjunct to colposcopy which can improve the diagnostic accuracy of detecting high grade squamous intraepithelial lesions

Objectives: Cervical cancer is rated fourth in terms of incidence and cancer-related mortality in women. Cytology-based screening programs and colposcopy provided insufficient rates of detecting cervical intraepithelial neoplasia (CIN) prompting researchers to develop new tools. The aim of this study was to evaluate whether folate receptor-mediated staining is useful in detecting CIN2+ during gynecological examination with colposcopy. Material and methods: In total 96 women with abnormal cytology findings were enrolled. The study was conducted on the Polish population. The diagnostic process consisted of colposcopy, receptor-mediated diagnosis (FRD), and histopathology examination. All women were subjected to the same diagnostic procedure. Results: The patient mean age of 96 women was 38 +/- 14.5 years. On colposcopy, high-grade lesions were detected in 83 women. The FRD gave positive results in 63 women. Histopathology revealed 1 case of carcinoma plano epithelial akeratodes, 21 cases of high-grade squamous intraepithelial lesions, 13 cases of low-grade squamous intraepithelial lesions. A total of 61 cases presented no pathology. FRD as an adjunct to colposcopy gave the following test results in detecting CIN2+ lesions: sensitivity - 94.29%, specificity - 46.67%, PPV - 50.77%, NPV - 93.33%, and accuracy - 64.21%. Using both techniques provided better results than using each of the tests alone. Conclusions: FRD is a promising test for the diagnosing CIN2+ cervical pathologies because it can increase the probability of detecting CIN2+ without any additional burden posed on patients. Further studies should be conducted on large and various populations to complement current evidence.