Independent determinants of inaccuracy of colposcopically directed punch biopsy of the cervix
The goal of this study was to determine the clinical factors independently associated with inaccuracy of colposcopically directed punch biopsy in defining extent and severity of epithelial lesions of the cervix. The study was conducted in a colposcopy clinic devoted to the management of patients wit...
Gespeichert in:
| Veröffentlicht in: | Gynecologic oncology 2003-07, Vol.90 (1), p.57-63 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 63 |
|---|---|
| container_issue | 1 |
| container_start_page | 57 |
| container_title | Gynecologic oncology |
| container_volume | 90 |
| creator | Costa, Silvano Nuzzo, Maria De Rubino, Anna Rambelli, Valeria Marinelli, Marica Santini, Donatella Cristiani, Paolo Bucchi, Lauro |
| description | The goal of this study was to determine the clinical factors independently associated with inaccuracy of colposcopically directed punch biopsy in defining extent and severity of epithelial lesions of the cervix.
The study was conducted in a colposcopy clinic devoted to the management of patients with abnormal Pap smear and/or histology diagnosis of cervical intraepithelial neoplasia (CIN) on punch biopsy or endocervical curettage. Seven hundred and thirty-nine patients (median age, 33 years; range, 18–83 years) referred with a punch biopsy diagnosis of CIN2–3 and treated with electrosurgical conization were evaluated. Cone histology diagnosis was assumed to supply the correct diagnosis. Two types of deviation of biopsy diagnosis were considered: (1) unconfirmed high-grade CIN diagnosis, defined as a cone diagnosis of CIN1 and reactive/reparative changes, and (2) nondiagnosis of carcinoma, defined as a cone diagnosis of microinvasive and invasive squamous carcinoma. Multinomial logistic regression analysis was used to assess the determinants of the probability of each type of deviation.
The probability of unconfirmed high-grade CIN diagnosis (
n = 190, 25.7%) was inversely related to number of quadrants involved, severity of referral Pap smear, and grade of biopsy. The probability of nondiagnosis of carcinoma (
n = 43, 5.8%) was positively related to patient age, invisibility of the squamocolumnar junction, number of quadrants involved, and cone width. Endo-ectocervical location, cone depth, and time period had no effect whatsoever.
The study confirmed previous observations regarding the positive association of patient age and invisibility of squamocolumnar junction with the probability of nondiagnosis of carcinoma. The concomitant positive effects of number of quadrants involved and cone width were suggested to mirror the effect of circumferential development and, respectively, surface area of CIN. Severity of referral Pap smear and grade of biopsy were shown to be inversely related to the probability of a cone diagnosis of CIN1 and benign changes. |
| doi_str_mv | 10.1016/S0090-8258(03)00202-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73414287</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0090825803002026</els_id><sourcerecordid>73414287</sourcerecordid><originalsourceid>FETCH-LOGICAL-c391t-c1bb45514c3bf7e22498c6ec1823a572eca7cfacba81acca6ca856ed9de3e8293</originalsourceid><addsrcrecordid>eNqFkElr3DAUgEVpyEyWn9DiS0N6cKPFsqVTKUPSDAz00OYYhPz8zKh4LFeyQ-bfR7PQOebyFvjewkfIJ0a_McrKu9-UaporLtUtFV8p5ZTn5QcyZ1TLvFRSfyTz_8iMXMT4l1IqKOPnZMa44kwUfE6el32DA6bQj1mDI4aN620_xsy3WaoApmBhu-vAd4OP4AcHtuu2WeMCwohNNkw9rLPa-SHuwXGNGWB4ca9X5Ky1XcTrY74kTw_3fxaP-erXz-XixyoHodmYA6vrQkpWgKjbCjkvtIISgSkurKw4gq2gtVBbxdJHtgSrZImNblCg4lpckpvD3iH4fxPG0WxcBOw626OfoqlEwQquqgTKAwjBxxiwNUNwGxu2hlGz82r2Xs1OmqHC7L2aMs19Ph6Y6g02p6mjyAR8OQI2Jj1tsD24eOIKLZSWReK-HzhMOl4cBhPBYQ94sGka79555Q13Gpbb</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>73414287</pqid></control><display><type>article</type><title>Independent determinants of inaccuracy of colposcopically directed punch biopsy of the cervix</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Costa, Silvano ; Nuzzo, Maria De ; Rubino, Anna ; Rambelli, Valeria ; Marinelli, Marica ; Santini, Donatella ; Cristiani, Paolo ; Bucchi, Lauro</creator><creatorcontrib>Costa, Silvano ; Nuzzo, Maria De ; Rubino, Anna ; Rambelli, Valeria ; Marinelli, Marica ; Santini, Donatella ; Cristiani, Paolo ; Bucchi, Lauro</creatorcontrib><description>The goal of this study was to determine the clinical factors independently associated with inaccuracy of colposcopically directed punch biopsy in defining extent and severity of epithelial lesions of the cervix.
The study was conducted in a colposcopy clinic devoted to the management of patients with abnormal Pap smear and/or histology diagnosis of cervical intraepithelial neoplasia (CIN) on punch biopsy or endocervical curettage. Seven hundred and thirty-nine patients (median age, 33 years; range, 18–83 years) referred with a punch biopsy diagnosis of CIN2–3 and treated with electrosurgical conization were evaluated. Cone histology diagnosis was assumed to supply the correct diagnosis. Two types of deviation of biopsy diagnosis were considered: (1) unconfirmed high-grade CIN diagnosis, defined as a cone diagnosis of CIN1 and reactive/reparative changes, and (2) nondiagnosis of carcinoma, defined as a cone diagnosis of microinvasive and invasive squamous carcinoma. Multinomial logistic regression analysis was used to assess the determinants of the probability of each type of deviation.
The probability of unconfirmed high-grade CIN diagnosis (
n = 190, 25.7%) was inversely related to number of quadrants involved, severity of referral Pap smear, and grade of biopsy. The probability of nondiagnosis of carcinoma (
n = 43, 5.8%) was positively related to patient age, invisibility of the squamocolumnar junction, number of quadrants involved, and cone width. Endo-ectocervical location, cone depth, and time period had no effect whatsoever.
The study confirmed previous observations regarding the positive association of patient age and invisibility of squamocolumnar junction with the probability of nondiagnosis of carcinoma. The concomitant positive effects of number of quadrants involved and cone width were suggested to mirror the effect of circumferential development and, respectively, surface area of CIN. Severity of referral Pap smear and grade of biopsy were shown to be inversely related to the probability of a cone diagnosis of CIN1 and benign changes.</description><identifier>ISSN: 0090-8258</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1016/S0090-8258(03)00202-6</identifier><identifier>PMID: 12821342</identifier><identifier>CODEN: GYNOA3</identifier><language>eng</language><publisher>San Diego, CA: Elsevier Inc</publisher><subject>Accuracy ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biopsy ; Biopsy, Needle - methods ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Cervical carcinoma ; Cervical intraepithelial neoplasia ; Cervical Intraepithelial Neoplasia - diagnosis ; Cervical Intraepithelial Neoplasia - pathology ; Cervical Intraepithelial Neoplasia - surgery ; Colposcopy - methods ; Conization ; Diagnostic Errors ; Electrosurgery ; Electrosurgical conization ; Female ; Female genital diseases ; Genital system. Mammary gland ; Gynecology. Andrology. Obstetrics ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Medical sciences ; Middle Aged ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Tumors ; Uterine Cervical Neoplasms - diagnosis ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - surgery</subject><ispartof>Gynecologic oncology, 2003-07, Vol.90 (1), p.57-63</ispartof><rights>2003 Elsevier Science (USA)</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-c1bb45514c3bf7e22498c6ec1823a572eca7cfacba81acca6ca856ed9de3e8293</citedby><cites>FETCH-LOGICAL-c391t-c1bb45514c3bf7e22498c6ec1823a572eca7cfacba81acca6ca856ed9de3e8293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0090-8258(03)00202-6$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14938954$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12821342$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Costa, Silvano</creatorcontrib><creatorcontrib>Nuzzo, Maria De</creatorcontrib><creatorcontrib>Rubino, Anna</creatorcontrib><creatorcontrib>Rambelli, Valeria</creatorcontrib><creatorcontrib>Marinelli, Marica</creatorcontrib><creatorcontrib>Santini, Donatella</creatorcontrib><creatorcontrib>Cristiani, Paolo</creatorcontrib><creatorcontrib>Bucchi, Lauro</creatorcontrib><title>Independent determinants of inaccuracy of colposcopically directed punch biopsy of the cervix</title><title>Gynecologic oncology</title><addtitle>Gynecol Oncol</addtitle><description>The goal of this study was to determine the clinical factors independently associated with inaccuracy of colposcopically directed punch biopsy in defining extent and severity of epithelial lesions of the cervix.
The study was conducted in a colposcopy clinic devoted to the management of patients with abnormal Pap smear and/or histology diagnosis of cervical intraepithelial neoplasia (CIN) on punch biopsy or endocervical curettage. Seven hundred and thirty-nine patients (median age, 33 years; range, 18–83 years) referred with a punch biopsy diagnosis of CIN2–3 and treated with electrosurgical conization were evaluated. Cone histology diagnosis was assumed to supply the correct diagnosis. Two types of deviation of biopsy diagnosis were considered: (1) unconfirmed high-grade CIN diagnosis, defined as a cone diagnosis of CIN1 and reactive/reparative changes, and (2) nondiagnosis of carcinoma, defined as a cone diagnosis of microinvasive and invasive squamous carcinoma. Multinomial logistic regression analysis was used to assess the determinants of the probability of each type of deviation.
The probability of unconfirmed high-grade CIN diagnosis (
n = 190, 25.7%) was inversely related to number of quadrants involved, severity of referral Pap smear, and grade of biopsy. The probability of nondiagnosis of carcinoma (
n = 43, 5.8%) was positively related to patient age, invisibility of the squamocolumnar junction, number of quadrants involved, and cone width. Endo-ectocervical location, cone depth, and time period had no effect whatsoever.
The study confirmed previous observations regarding the positive association of patient age and invisibility of squamocolumnar junction with the probability of nondiagnosis of carcinoma. The concomitant positive effects of number of quadrants involved and cone width were suggested to mirror the effect of circumferential development and, respectively, surface area of CIN. Severity of referral Pap smear and grade of biopsy were shown to be inversely related to the probability of a cone diagnosis of CIN1 and benign changes.</description><subject>Accuracy</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Biopsy, Needle - methods</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Cervical carcinoma</subject><subject>Cervical intraepithelial neoplasia</subject><subject>Cervical Intraepithelial Neoplasia - diagnosis</subject><subject>Cervical Intraepithelial Neoplasia - pathology</subject><subject>Cervical Intraepithelial Neoplasia - surgery</subject><subject>Colposcopy - methods</subject><subject>Conization</subject><subject>Diagnostic Errors</subject><subject>Electrosurgery</subject><subject>Electrosurgical conization</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Genital system. Mammary gland</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</subject><subject>Tumors</subject><subject>Uterine Cervical Neoplasms - diagnosis</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - surgery</subject><issn>0090-8258</issn><issn>1095-6859</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkElr3DAUgEVpyEyWn9DiS0N6cKPFsqVTKUPSDAz00OYYhPz8zKh4LFeyQ-bfR7PQOebyFvjewkfIJ0a_McrKu9-UaporLtUtFV8p5ZTn5QcyZ1TLvFRSfyTz_8iMXMT4l1IqKOPnZMa44kwUfE6el32DA6bQj1mDI4aN620_xsy3WaoApmBhu-vAd4OP4AcHtuu2WeMCwohNNkw9rLPa-SHuwXGNGWB4ca9X5Ky1XcTrY74kTw_3fxaP-erXz-XixyoHodmYA6vrQkpWgKjbCjkvtIISgSkurKw4gq2gtVBbxdJHtgSrZImNblCg4lpckpvD3iH4fxPG0WxcBOw626OfoqlEwQquqgTKAwjBxxiwNUNwGxu2hlGz82r2Xs1OmqHC7L2aMs19Ph6Y6g02p6mjyAR8OQI2Jj1tsD24eOIKLZSWReK-HzhMOl4cBhPBYQ94sGka79555Q13Gpbb</recordid><startdate>20030701</startdate><enddate>20030701</enddate><creator>Costa, Silvano</creator><creator>Nuzzo, Maria De</creator><creator>Rubino, Anna</creator><creator>Rambelli, Valeria</creator><creator>Marinelli, Marica</creator><creator>Santini, Donatella</creator><creator>Cristiani, Paolo</creator><creator>Bucchi, Lauro</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030701</creationdate><title>Independent determinants of inaccuracy of colposcopically directed punch biopsy of the cervix</title><author>Costa, Silvano ; Nuzzo, Maria De ; Rubino, Anna ; Rambelli, Valeria ; Marinelli, Marica ; Santini, Donatella ; Cristiani, Paolo ; Bucchi, Lauro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-c1bb45514c3bf7e22498c6ec1823a572eca7cfacba81acca6ca856ed9de3e8293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Accuracy</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Biopsy, Needle - methods</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Cervical carcinoma</topic><topic>Cervical intraepithelial neoplasia</topic><topic>Cervical Intraepithelial Neoplasia - diagnosis</topic><topic>Cervical Intraepithelial Neoplasia - pathology</topic><topic>Cervical Intraepithelial Neoplasia - surgery</topic><topic>Colposcopy - methods</topic><topic>Conization</topic><topic>Diagnostic Errors</topic><topic>Electrosurgery</topic><topic>Electrosurgical conization</topic><topic>Female</topic><topic>Female genital diseases</topic><topic>Genital system. Mammary gland</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques</topic><topic>Tumors</topic><topic>Uterine Cervical Neoplasms - diagnosis</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Costa, Silvano</creatorcontrib><creatorcontrib>Nuzzo, Maria De</creatorcontrib><creatorcontrib>Rubino, Anna</creatorcontrib><creatorcontrib>Rambelli, Valeria</creatorcontrib><creatorcontrib>Marinelli, Marica</creatorcontrib><creatorcontrib>Santini, Donatella</creatorcontrib><creatorcontrib>Cristiani, Paolo</creatorcontrib><creatorcontrib>Bucchi, Lauro</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Costa, Silvano</au><au>Nuzzo, Maria De</au><au>Rubino, Anna</au><au>Rambelli, Valeria</au><au>Marinelli, Marica</au><au>Santini, Donatella</au><au>Cristiani, Paolo</au><au>Bucchi, Lauro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Independent determinants of inaccuracy of colposcopically directed punch biopsy of the cervix</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>90</volume><issue>1</issue><spage>57</spage><epage>63</epage><pages>57-63</pages><issn>0090-8258</issn><eissn>1095-6859</eissn><coden>GYNOA3</coden><abstract>The goal of this study was to determine the clinical factors independently associated with inaccuracy of colposcopically directed punch biopsy in defining extent and severity of epithelial lesions of the cervix.
The study was conducted in a colposcopy clinic devoted to the management of patients with abnormal Pap smear and/or histology diagnosis of cervical intraepithelial neoplasia (CIN) on punch biopsy or endocervical curettage. Seven hundred and thirty-nine patients (median age, 33 years; range, 18–83 years) referred with a punch biopsy diagnosis of CIN2–3 and treated with electrosurgical conization were evaluated. Cone histology diagnosis was assumed to supply the correct diagnosis. Two types of deviation of biopsy diagnosis were considered: (1) unconfirmed high-grade CIN diagnosis, defined as a cone diagnosis of CIN1 and reactive/reparative changes, and (2) nondiagnosis of carcinoma, defined as a cone diagnosis of microinvasive and invasive squamous carcinoma. Multinomial logistic regression analysis was used to assess the determinants of the probability of each type of deviation.
The probability of unconfirmed high-grade CIN diagnosis (
n = 190, 25.7%) was inversely related to number of quadrants involved, severity of referral Pap smear, and grade of biopsy. The probability of nondiagnosis of carcinoma (
n = 43, 5.8%) was positively related to patient age, invisibility of the squamocolumnar junction, number of quadrants involved, and cone width. Endo-ectocervical location, cone depth, and time period had no effect whatsoever.
The study confirmed previous observations regarding the positive association of patient age and invisibility of squamocolumnar junction with the probability of nondiagnosis of carcinoma. The concomitant positive effects of number of quadrants involved and cone width were suggested to mirror the effect of circumferential development and, respectively, surface area of CIN. Severity of referral Pap smear and grade of biopsy were shown to be inversely related to the probability of a cone diagnosis of CIN1 and benign changes.</abstract><cop>San Diego, CA</cop><pub>Elsevier Inc</pub><pmid>12821342</pmid><doi>10.1016/S0090-8258(03)00202-6</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0090-8258 |
| ispartof | Gynecologic oncology, 2003-07, Vol.90 (1), p.57-63 |
| issn | 0090-8258 1095-6859 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_73414287 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Accuracy Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Biopsy Biopsy, Needle - methods Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Cervical carcinoma Cervical intraepithelial neoplasia Cervical Intraepithelial Neoplasia - diagnosis Cervical Intraepithelial Neoplasia - pathology Cervical Intraepithelial Neoplasia - surgery Colposcopy - methods Conization Diagnostic Errors Electrosurgery Electrosurgical conization Female Female genital diseases Genital system. Mammary gland Gynecology. Andrology. Obstetrics Humans Investigative techniques, diagnostic techniques (general aspects) Medical sciences Middle Aged Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques Tumors Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - surgery |
| title | Independent determinants of inaccuracy of colposcopically directed punch biopsy of the cervix |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T02%3A32%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Independent%20determinants%20of%20inaccuracy%20of%20colposcopically%20directed%20punch%20biopsy%20of%20the%20cervix&rft.jtitle=Gynecologic%20oncology&rft.au=Costa,%20Silvano&rft.date=2003-07-01&rft.volume=90&rft.issue=1&rft.spage=57&rft.epage=63&rft.pages=57-63&rft.issn=0090-8258&rft.eissn=1095-6859&rft.coden=GYNOA3&rft_id=info:doi/10.1016/S0090-8258(03)00202-6&rft_dat=%3Cproquest_cross%3E73414287%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=73414287&rft_id=info:pmid/12821342&rft_els_id=S0090825803002026&rfr_iscdi=true |