Detection of cervical cancer and its precursors by endocervical curettage in 13,115 colposcopically guided biopsy examinations

作者：Gage Julia C^*; Duggan Maire A; Nation Jill G; Gao Song; Castle Philip E

来源：American Journal of Obstetrics and Gynecology, 2010, 203(5): 481.e1.

DOI：10.1016/j.ajog.2010.06.048

• cervical intraepithelial neoplasia
• colposcopy
• curettage
• diagnosis
• endocervical sampling

OBJECTIVE: Endocervical curettage (ECC) specimens obtained during colposcopy can detect cervical cancer and precursors otherwise missed by biopsy alone, but the procedure can be painful and reduce compliance with needed follow-up. ECC is routinely performed in the Calgary Health Region colposcopy clinics, permitting a look at its real-world utility.
STUDY DESIGN: We analyzed pathology and colposcopy reports from 2003 to 2007. We calculated the added diagnostic utility of ECC compared with cervical biopsy alone.
RESULTS: ECC increased the diagnostic yield of cervical intraepithelial neoplasia grade 2 or worse (cervical intraepithelial neoplasia [CIN]2+) in 1.01% of 13,115 colposcopically guided biopsy examinations. Therefore, 99 ECC specimens were taken to detect 1 additional CIN2+. ECC detected 5.4% of 2443 CIN2+ subjects otherwise missed by biopsy alone. Utility was greatest among women aged 46 years or older referred after a high-grade cytology.
CONCLUSION: ECC is rarely informative when used routinely in colposcopic practice. Older women referred after high-risk cytology benefit most from ECC.

• 出版日期2010-11
• 单位NIH