Combined Colposcopic Index of Reid and Scalzi

Description

Reid et al initially proposed an index for pre-malignant human papillomavirus (HPV) lesions of the cervix based on the colposcopic appearance in 1984. This was modified by Reid and Scalzi in 1985 as the Combined Colposcopic Index. Each parameter is independent of each other, allowing a simple additive scoring.

Parameters observed during colposcopy:

(1) margin

(2) color

(3) vessels

(4) appearance after iodine staining

Parameter	Finding	Points
margin	one or more of the following: condylomatous or micropapillary contour; indistinct acetowhitening; flocullated or feathered margins; angular, jagged lesions; satellite lesions and acetowhitening that extends beyond the transformation zone	0
	regular lesions with smooth, straight outlines	1
	rolled, peeling edges	2
	internal demarcations between areas of differing appearance	2
color	shiny, snow-white color, with indistinct acetowhitening	0
	intermediate shade (shiny gray)	1
	dull, oyster-white	2
vessels	fine-caliber vessels with a poorly formed pattern; condylomatous or micropapillary lesions	0
	absent vessels	1
	definite punctation	2
	mosaic	2
iodine	positive iodine staining	0
	minor iodine negativity	0
	partial iodine uptake	1
	negative staining of a significant lesion	2

from Table II, page 614, Reid and Scalzi (1985)

combined colposcopic index (CCI) =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 8

• The score can allow separation of subclinical HPV infection from high grade dysplasia, but overlaps with low grade dysplasia.

CCI	Diagnosis
0 –2	subclinical HPV disease or CIN I
3 - 5	CIN I or II
6 - 8	CIN II or III

	CCI 0 – 2	CCI 3 – 5	CCI 6 - 8
subclinical HPV	18	0	0
CIN I	9	5	1
CIN II	0	8	8
CIN III	0	1	22

data from Figure 12, page 617, Reid and Scalzi (1985)

Performance:

• The original article reported a diagnostic accuracy of 97%

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Description

Specialty

ICD-10