Yield of endocervical curettage in detecting cervical intraepithelial neoplasia grade 2 or higher during colposcopy: A prospective, cross-sectional study

IF 2.6 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Nida Jareemit, Lalita Theerarojanapong, Natthawadee Laokulrath, Vuthinun Achariyapota, Khemanat Khemworapong, Sompop Kuljarasnont, Pornporm Ittiamornlert, Vitcha Poonyakanok, Perapong Inthasorn
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Abstract

Objective

This study assessed the prevalence and factors associated with detecting cervical intraepithelial neoplasia grade 2 or higher (CIN2+) via endocervical curettage (ECC) during colposcopy.

Methods

Between December 2020 and September 2023, a prospective, cross-sectional study involving women with abnormal cervical cancer screening results who underwent colposcopy was conducted. ECC was performed via a Kevorkian endocervical curette following colposcopy-directed biopsy. The exclusion criteria were glandular cytology abnormalities, pregnancy, post-hysterectomy status, and cervical cancer.

Results

The study included 569 women, with a mean age of 41.6 ± 11.7 years. Among the participants, 78.9% presented with low-grade cytology, whereas 21.1% presented with high-grade cytology. All of the patients underwent ECC, with 0.4% (two patients) yielding inadequate samples. ECC detected CIN2+ lesions in 11.6% of the patients (95% confidence interval [CI], 9–14.3). Univariable analysis revealed that age, menopausal status, history of CIN2+, high-grade cytology, and high-grade colposcopy impression were significant factors for CIN2+ detection by ECC. Multivariable analysis confirmed high-grade cytology as the sole independent factor (adjusted odds ratio [OR], 13.81 [95% CI, 4.60–41.42], P < 0.001). ECC added a diagnostic yield of 2.9% (95% CI, 1.5–4.3) for detecting CIN2+ lesions missed by colposcopy-directed biopsy. Multivariable analysis demonstrated an independent association between human papillomavirus 16 (HPV-16) infection and the additional diagnostic benefit of ECC, with an adjusted odds ratio (OR) of 6.26 (95% CI, 1.49–26.23, P = 0.012).

Conclusion

This study highlights the critical role of ECC in detecting CIN2+ lesions, particularly in patients with high-grade cytology or HPV-16 positivity.

阴道镜检查期间宫颈内膜刮除检测宫颈上皮内瘤变2级或以上的结果:一项前瞻性横断面研究。
目的:本研究评估阴道镜检查时宫颈内膜刮除术(ECC)检测宫颈上皮内瘤变2级及以上(CIN2+)的患病率及相关因素。方法:在2020年12月至2023年9月期间,对接受阴道镜检查的宫颈癌筛查结果异常的妇女进行前瞻性横断面研究。ECC在阴道镜指导下活检后通过Kevorkian宫颈内刮匙进行。排除标准为腺细胞学异常、妊娠、子宫切除术后状态和宫颈癌。结果:纳入569例女性,平均年龄41.6±11.7岁。在参与者中,78.9%的人表现为低级别细胞学,21.1%的人表现为高级别细胞学。所有患者都接受了ECC,其中0.4%(2例)的样本不足。ECC在11.6%的患者中检测到CIN2+病变(95%可信区间[CI], 9-14.3)。单变量分析显示,年龄、绝经状态、CIN2+病史、高级别细胞学检查、高级别阴道镜印模是ECC检测CIN2+的显著因素。多变量分析证实高级别细胞学检查是唯一的独立因素(校正优势比[OR], 13.81 [95% CI, 4.60-41.42]), P结论:本研究强调了ECC在检测CIN2+病变中的关键作用,特别是在高级别细胞学检查或HPV-16阳性患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.80
自引率
2.60%
发文量
493
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecology & Obstetrics publishes articles on all aspects of basic and clinical research in the fields of obstetrics and gynecology and related subjects, with emphasis on matters of worldwide interest.
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