Cherif Akladios1, Lise Lecointre1, Emmanuelle Baulon1, Veronique Thoma1, Gerlinde Averous2, Muriel Fender3, François Lefebvre4, Jean-Jacques Baldauf5. 1. Department of Obstetrics and Gynecology, University Hospital of Hautepierre, Strasbourg, France. 2. Department of Pathology, University Hospital of Hautepierre, Strasbourg, France. 3. EVE Association, Graffenstaden, France. 4. Methodology and Biostatistics Sector, Public Health Department, Strasbourg University Hospitals, Strasbourg, France. 5. Department of Obstetrics and Gynecology, University Hospital of Hautepierre, Strasbourg, France Jean-Jacques.Baldauf@chru-strasbourg.fr.
Abstract
AIM: To analyze the reliability of endocervical curettage (ECC) in the diagnosis of high-grade cervical intraepithelial neoplasia and cervical cancer, and to identify risk factors associated with diagnostic underestimation. MATERIALS AND METHODS: A retrospective study was carried-out involving 445 patients who underwent ECC for: endocervical lesion incompletely visible on colposcopy or inaccessible to biopsy; atypical glandular cells on smear, or discrepancy between colposcopic impression and cytological abnormalities. RESULTS: Comparison between ECC and final diagnosis showed a perfect match in 362 patients (81.3%). For 189 patients with pre-cancerous or cancerous endocervical lesions, the sensitivity, specificity, and positive and negative predictive values were 87.3%, 96.9%, 95.4% and 91.9%, respectively. No clinical, cytological or colposcopic characteristics were associated with significantly increased risk of diagnostic underestimation with ECC. CONCLUSION: ECC is a very reliable tool for reducing the number of unnecessary treatments, without increasing the risk of allowing some lesions to evolve into cancer. Copyright
AIM: To analyze the reliability of endocervical curettage (ECC) in the diagnosis of high-grade cervical intraepithelial neoplasia and cervical cancer, and to identify risk factors associated with diagnostic underestimation. MATERIALS AND METHODS: A retrospective study was carried-out involving 445 patients who underwent ECC for: endocervical lesion incompletely visible on colposcopy or inaccessible to biopsy; atypical glandular cells on smear, or discrepancy between colposcopic impression and cytological abnormalities. RESULTS: Comparison between ECC and final diagnosis showed a perfect match in 362 patients (81.3%). For 189 patients with pre-cancerous or cancerous endocervical lesions, the sensitivity, specificity, and positive and negative predictive values were 87.3%, 96.9%, 95.4% and 91.9%, respectively. No clinical, cytological or colposcopic characteristics were associated with significantly increased risk of diagnostic underestimation with ECC. CONCLUSION: ECC is a very reliable tool for reducing the number of unnecessary treatments, without increasing the risk of allowing some lesions to evolve into cancer. Copyright