Inner border--a specific and significant colposcopic sign for moderate or severe dysplasia (cervical intraepithelial...

Investigation of the correlation between the colposcopic sign inner border and cervical intraepithelial neoplasia (CIN) 2 or 3 and its association with specific human papillomavirus (HPV) types and the age of the patient.

Colpophotographs or cervicograms were taken from 947 women referred due to an abnormal cervical finding. Occurrence of the colposcopic sign inner border was evaluated retrospectively by 2 independent colposcopists. Histologic evaluation was based on punch or cone biopsies. Human papillomavirus testing was done using Hybrid Capture I or a polymerase chain reaction-based HPV test.

The prevalence of the colposcopic phenomenon inner border in women with an atypical transformation zone was 7.6% (53/695). In 70% of women with inner border, CIN 2 or 3 was confirmed histologically. The sensitivity of the colposcopic sign inner border for detection of CIN 2 or 3 was 20%, and the specificity was 97%. In patients with inner border, the odds ratio for CIN 2 or 3 was 7.7 (95% CI=4.2-14.3). There was no significant association between inner border and any high-risk HPV type. Cervical intraepithelial neoplasia 2 or 3 associated with inner border was significantly more frequent in patients younger than 35 years.

Inner border is a rare colposcopic phenomenon but highly specific for CIN 2 or 3 in young women.