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It was our purpose for thin study to evaluate the accuracy of colposcopic examination in the diagnosis of cervical disease, especially in the detection of early cervical cencer. From October 1974 through August 1976, colposcopic examinations were taken in a series of 789 patients registered at Uterine cancer Clinic, Catholic Medical college. Among them, we selected 380 cases, who was taken cytology and biopsy tor the evaluation of the accuracy of colposcopic examination. At the time of colposcopic examination, findings were documented by color colpophotography. patients were distributed into three major groups ; 1. Patients with negative colposcpy; This group incluede patients in the cases of the squamocolumnar junction was fully visible, but no focal colposcopic lesion was either positive or revealed repeatedly suspicious. Conization was performed in these cases, regadless of negative colposcopy, to evaluate the false negative rate of colposcopy. 2. patients with a focal colposcopic lesion; In these patients, a selective biopsy was performed under colposcopic vision, using a Kevirkian-Yunge biopsy forceps. Before the biopsy, the colposcopic impression of the anticipated cervical pathology was recorede. This impression was based on Kolstad`s five diagnostic criteria of the focal lesion; 1) vascular pattern, 2) intercapillary distance, 3) surface contour tone, and 4) clarity of demarcation of the lesion. 3. patients with unsatisfacuory colposcopy; In patients in whom the squamocolumnar junction was not fully visible, cloposcopy was classified as unsatisfactory because a more severe lesion higher in the endocervical canal could not be excluede. ig the referring cytology was positive or repeatedly suspicious, diagnostic conization or fractional biopsy was recommended. According to the above protocol, we examined 380 cases. A focal colposcopic lesion was found in 228 patients (60.0%); colposcopy was negative in 141 (37.1%) and unsatisfactory in 11 patients (2.8%) The results were as follows; 1. colposcopic examination was a valuable adjunct in diagnosis of lesions of the cervix, espedially in invlammatory or malignant lesions. 2. the combination of cytology and colposcopic selective biopsy diminished the falws negative rate under that of each method separately. 3. Selective biopsy under colposcopy could reduce an unnecessary tissue damage resulted from random or cone biopsies. 4. For the low falwe-positive rate, a correct estimation of each colposcopic finding was needed by skilled and experienced colposcopist. 5. Malignancy rate was higher when the lesion revealed several abnormal colposcopic findings mixed than single finding. 6. Colposcopic examination was available and/ or helpful in the following-up and in make range of the focal lesions.
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