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Using Cytology to Evaluate the Endocervical Canal After Loop Excision

Dinh, Tri A. MD*; Schnadig, Vicki J. MD; Logrono, Roberto MD; Hannigan, Edward V. MD*; Santoso, Joseph T. MD*

Journal of Lower Genital Tract Disease:
Original Articles
Abstract

Objective: This study assesses cytology to evaluate the endocervical canal immediately after loop excision.

Material and Methods: In 103 patients, we performed a cytologic smear and endocervical curettage immediately after loop excision. Diagnoses were made independently by two cytopathologists and compared to histology. Diagnostic agreement was evaluated statistically.

Results: Cytopathologist “A” found a sensitivity of 1.0, specificity of 0.9, positive predictive value (PPV) of 0.44 and negative predictive value (NPV) of 1.0. Cytopathologist “B” found a sensitivity of 0.88, specificity of 0.78, PPV of 0.3 and NPV of 0.98. There was good agreement between the two cytopathologists (kappa = 0.42, 95% CI = 0.25, 0.60). Twenty-five endocervical curettage specimens were insufficient for diagnosis. Seven and 4 cytology specimens were judged unsatisfactory by each cytopathologist, respectively. Histologic and cytologic evaluation charges were $283 and $60.50 per patient, respectively.

Conclusion: The use of cytology efficiently evaluates the endocervical canal after loop excision.

Author Information

*Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, TX

Department of Pathology, The University of Texas Medical Branch, Galveston, TX

Reprint requests to: Tri A. Dinh, MD, Massachusetts General Hospital, 55 Fruit Street, VBK 113, Boston, MA 02114.

©2002The American Society for Colposcopy and Cervical Pathology