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Evaluation of Endocervical Canal in Women With Minimal Cervical Cytological Abnormalities

Goksedef, B. Pinar Cilesiz MD1; Akbayir, Ozgur MD2; Numanoglu, Ceyhun MD2; Corbacioglu, Aytul MD2; Guraslan, Hakan MD3; Bakir, Lale Vuslat MD2; Kaya, Onur MD1; Yanik, Gulden MD2; Cetin, Ahmet MD1

Journal of Lower Genital Tract Disease: July 2013 - Volume 17 - Issue 3 - p 261–266
doi: 10.1097/LGT.0b013e31826b68c7
Original Articles

Objective: This study aimed to examine the endocervical canal curettage (ECC) results of patients with atypical squamous cells of undetermined significance (ASC-US) or low-grade intraepithelial lesion (LSIL) and secondarily to explore the features of patients who are at greatest risk for endocervical involvement.

Materials and Methods: This is a retrospective analysis of 846 women who underwent ECC with ASC-US or LSIL on cervical cytology between January 2003 and April 2011. Records of demographic data and colposcopic impression were evaluated. Histopathological results of biopsies and ECC were classified into 2 categories as less than cervical intraepithelial lesion 2 (CIN 2) and CIN 2+ lesions for comparison. Multivariate analysis was performed using binary logistic regression analysis to identify predictors of ECC results.

Results: CIN 1 lesions were detected in 8.9% of patients, and the rates of CIN 2 or 3 and invasive/microinvasive cancers in ECC were 3.8% and 0.7%, respectively. Cervical intraepithelial lesion 2 or worse lesions were detected in 1.6% (7/419) of the patients with normal colposcopic findings. There was no statistically significant difference in the rate of CIN 2+ lesion in endocervical canal between the patients with or without satisfactory colposcopic examination (4.4% vs 4.1% p = .69). A total of 1.7% of the patients who did not have cervical biopsy and also 1.1% of the patients who had less than CIN 2 biopsy results were diagnosed with CIN 2+ lesion by ECC despite the satisfactory colposcopy. Only a positive biopsy result for dysplasia was found to be an independent factor for the detection of a dysplastic lesion in endocervical canal (odds ratio = 0.06; 95% CI = 0.01–0.35; p = .02).

Conclusions: Endocervical canal curettage had minimal diagnostic utility for the detection of CIN 2 or worse lesions in women with ASC-US or LSIL smear result and normal colposcopic findings. In addition to this, the presence or absence of CIN 2+ lesions diagnosed by means of endocervical curettage was independent of a satisfactory or unsatisfactory colposcopic examination.

1Obstetrics and Gynecology, Haseki Teaching and Research Hospital; 2Obstetrics and Gynecology, Kanuni Sultan Suleyman Teaching and Research Hospital; and 3Obstetrics and Gynecology, Bakirkoy Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey.

Reprint requests to: B. Pinar Cilesiz, MD, Haseki Egitim ve Arastirma Hastanesi Kadin Dogum Klinigi Aksaray, Istanbul, Turkey. E-mail: bpgoksedef@yahoo.com

There are no potential conflicts or financial interest by the authors involved this study.

Copyright © 2013 by the American Society for Colposcopy and Cervical Pathology