Endocervical curettage : Does it Contribute to the Management of Patients with Abnormal Cervical Cytology?

Kim, Ja Yeon; Lee, Chae Hyung; Kang, Sokbom; Jeon, Yong Tark; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang; Kang, Soon Beom; Lee, Hyo Pyo

Abstract

OBJECTIVE
: This retrospective study is aimed to investigate whether, when endocervical curettage (ECC) is added to colposcopy-directed punch biopsy (CdpBx) to the patients who have abnormal cervical cytology, the diagnostic value is differed or not.
METHODS
: The records of 140 women with abnormal cervical cytology who were examined by CdpBx with ECC at Seoul National University Hospital from June 1997 to March 2003 were reviewed. The number of the patients whose results of ECC were different from those of CdpBx was counted.
RESULTS
: ECC combined with CdpBx failed to show any superiority compared to CdpBx alone in the positive predictive value of cervical cancer (83% vs. 77%; p=0.8). When performed with CdpBx, ECC didn't contribute to the management of patients with abnormal cervical cytology because it provided the information, which have shifted up treatment plan (i.e., from follow-up with smears to any immediate intervention or from local ablation therapy to radical therapy) in only 9 (6%) of 140 cases. In two cases of which treatment plan have shifted up because of ECC information, cervical cytology results were AGUS of which proportion is 1% of total cases.
CONCLUSION
: When combined with CdpBx, ECC does not help to increase diagnostic value. The use of ECC would be helpful to the case in which the cervical cytology result is AGUS.