The role of endocervical curettage in
detection and treatment of cervical canal lesions
Lin Lang*, Ying Jia*, Zhaoning Duan, Jin Wu, Ming Luo and Pu Tian
Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
*contributed equally
Corresponding Author: Ying Jia, Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China. e-mail: jy03261@163.com
Summary. Objective. To screen out high-risk groups of endocervical lesions, explore the effect of length of excision on margin status in women with abnormal endocervical curettage (ECC) and explore the role of ECC in the additional detection of high-grade squamous intraepithelial lesion or worse (HSIL+) under colposcopy and lesion-targeted biopsies.
Methods. The study included 936 patients who underwent loop electrosurgical excision procedure (LEEP) for cervical lesions which were diagnosed by cervical biopsy and ECC at the cervical clinic of the First Affiliated Hospital of Chongqing Medical University from January 2014 and December 2018. The correlations among abnormal ECC, human papilloma-virus (HPV) type, cytology, margin of excision, and age were analyzed by Pearson's χ2 test and multivariate logistic regression analysis.
Results. Abnormal ECC was associated with HPV-16 infection (P<0.001), or HSIL cervical cytology or worse (P<0.001), or aged 50 years old or older (P<0.001). Abnormal ECC was associated with positive margin of excision (P<0.001). For patients with abnormal ECC, the length of excision was independent of margin status (P=0.762). Among all the 491 patients with HSIL+ diagnosed by either cervical biopsy or ECC, the additional detection rate of HSIL+ by ECC was only 8.76% (43/491).
Conclusion. In our study, ECC was recommended in women with HPV-16 infection, HSIL cervical cytology or worse, aged 50 or older, or invisible transformation zone in colposcopy. At the same time, our results suggested that ECC abnormalities were associated with positive margin of excision. The data did not support performing a longer length of excision in patients with abnormal ECC, especially in women with fertility needs. In summary, patients with abnormal ECC should be given more attention and follow-up to avoid missing residual lesions. Histol Histopathol 37, 63-68 (2022)
Key words: Endocervical curettage, Cervical lesions, Human papillomavirus
DOI: 10.14670/HH-18-394
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©The Author(s) 2022. Open Access. This article is licensed under a Creative Commons CC-BY International License. |