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The Utility of Routine Endocervical Curettage at the Time ofColposcopy for Low-grade Cytologic Abnormalities toImprove Diagnosis of High-grade Diseases |
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| รหัสดีโอไอ | |
| Creator | Chanakarn Suebthawinkul, M.D. |
| Title | The Utility of Routine Endocervical Curettage at the Time ofColposcopy for Low-grade Cytologic Abnormalities toImprove Diagnosis of High-grade Diseases |
| Publisher | PIMDEE Co., Ltd. |
| Publication Year | 2559 |
| Journal Title | Thai Journal of Obstetrics and Gynaecology |
| Journal Vol. | 24 |
| Journal No. | 2 |
| Page no. | 128-135 |
| Keyword | Endocervical curettage, Low-grade squamous intraepithelial lesion, LSIL, ColposcopyECC |
| ISSN | 0857-6084 |
| Abstract | Objective: To determine the use of endocervical curettage(ECC) at the time of colposcopy forlow-grade cytologic abnormalities to improve the diagnosis of high-grade diseases.Materials and methods: A prospective diagnostic study was conducted. We included women withlow-grade cytologic abnormalities: low-grade squamous intraepithelial lesion (LSIL) who hadundergone colposcopy at Chonburi Hospital between January 2014 to March 2015. Datacollected were age, menopausal status, HIV status, parity, contraception, colposcopic fidingsand pathological report of biopsy and ECC.Main outcome measure: Primary outcome was the increasing rate of ECC in colposcopy for LSILto detect high-grade lesion.Result: Eighty-seven women met criteria. Nine cases (10.3%) were ECC positive for highgrade lesion. Of these nine cases, seven cases were only ECC positive, resulting in 8.04%increased detection with ECC independently of biopsy, with a sensitivity of 20.0%, specifiityof 91.91%, positive predictive value of 22.22% and negative predictive value of 89.74%.Therefore, twelve to thirteen ECCs needed to be performed to detect one case of high-gradediseases. Among post-menopausal women or women older than 40 years old, the sensitivityof ECC improved, with a sensitivity of 100% and 85% respectively.Conclusion: The increased detection rate of ECC to detect high-grade lesions in women who hadlow-grade cytological abnormalities in our study was 8.04%. Routine ECC at the time ofcolposcopy for LSIL in young women is debatable. However, the sensitivity of ECC was foundto be increased in women aged over 40 and post-menopausal women. Therefore, ECC maybe useful in older and post-menopausal women. |
