Introduction/Background Early detection of preinvasive lesions and cervical cancer depend on the correlation of the cytology, HPV result and the colposcopic findings. Although recent advances in liquid-based cytology and HPV testing have led to better detection of cervical preinvasive lesions, however their effectiveness is limited by the diagnostic performance of colposcopy. In spite of its clinical significance, interobserver variability limits its efficacy and different results were reported for its accuracy.Therefore, for the identification of lesions that may progress to cervical cancer, defined colposcopic criteria which include pathognomonic and grading signs in guidelines and various studies. . These pathognomonic criteria are inner border sign, ridge sign, rag sign and cuffed crypt openings. The primary goal of the present retrospective study was to evaluate the diagnostic accuracy of four colposcopic pathognomonic signs in detecting CIN2+ and association with HPV types.

Methodology We retrospectively reviewed, patients who applied to our colposcopy unit between January 1, 2018 and December 31, 2019 and who underwent colposcopy for the first time were included in the study.

Results In table 1, sensitivity, specificity, positive and negative likelihood (95% CI), and positive and negative predictive values of colposcopy results are given. The sensitivity of the Ridge sign was 9.06%, the specificity was 98.78%, the LR+ value was 7.40, and the LR- value was 0.92. Rag sign had a sensitivity of 12.54%, a specificity of 95.37%, a LR+ value of 2.71, and a LR- value of 0.92. Cuffed crypt had a sensitivity of 21.25%, a specificity of 88.29%, an LR+ value of 1.81, and an LR- value of 0.89. There is a significant relationship between HPV status and Colposcopy+Histology χ2(3) = 141.149, p<.001.

Conclusion The morphology of the four pathognomonic colposcopic criteria is highly associated with CIN 2 or CIN 3 and HPV status.

Disclosures We declare that we have no conflict of interest.