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J Low Genit Tract Dis. 2014 Jan;18(1):21-5. doi: 10.1097/LGT.0b013e31828ce581.

Evaluation of cervical biopsies guided by visual inspection with acetic acid.

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Departments of 1Gynaecology and Obstetrics and 2Pathology, Faculty of Medicine, Minia University, El-Minia, Egypt.



To evaluate the accuracy of visual inspection with acetic acid (VIA) in determining the site, the size, and the number of cervical biopsies in patients with positive cervical cytology.


This study included 486 patients with positive cervical cytology who presented to the Gynaecological Oncology Unit of Minia Maternity University Hospital, Egypt, in the period between January 2008 and September 2011. Visual inspection with acetic acid was done for all patients. They were classified into 2 groups according to the results of VIA. Group 1 included VIA-negative women, whereas group 2 included VIA-positive women. All patients were reexamined with colposcopy to prove or disprove the presence of lesions. Cervical biopsies were taken from patients with positive VIA or colposcopically confirmed lesions using punch biopsy forceps. Biopsies were sent for histologic examination.


In group 1, 100 patients were VIA-negative, 66 of them were histopathologically free, whereas 34 patients had positive biopsy results. Group 2 included 386 patients: 31 were histologically free, 239 had cervical intraepithelial neoplasia (CIN) 1, whereas 116 had CIN 2 or worse.


Visual inspection with acetic acid is a good test for aiding the diagnosis of CIN and may be helpful in determining the site, the size, and the number of biopsies in patients with positive cytologic results. Instead of colposcopy, VIA can be used in developing countries where colposcopic services are not available.

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