Yield of endocervical curettage in detecting cervical intraepithelial neoplasia grade 2 or higher during colposcopy: A prospective, cross-sectional study
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Issued Date
2024-01-01
Resource Type
ISSN
00207292
eISSN
18793479
Scopus ID
2-s2.0-85211092468
Journal Title
International Journal of Gynecology and Obstetrics
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Gynecology and Obstetrics (2024)
Suggested Citation
Jareemit N., Theerarojanapong L., Laokulrath N., Achariyapota V., Khemworapong K., Kuljarasnont S., Ittiamornlert P., Poonyakanok V., Inthasorn P. Yield of endocervical curettage in detecting cervical intraepithelial neoplasia grade 2 or higher during colposcopy: A prospective, cross-sectional study. International Journal of Gynecology and Obstetrics (2024). doi:10.1002/ijgo.16074 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/102388
Title
Yield of endocervical curettage in detecting cervical intraepithelial neoplasia grade 2 or higher during colposcopy: A prospective, cross-sectional study
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Abstract
Objective: This study assessed the prevalence and factors associated with detecting cervical intraepithelial neoplasia grade 2 or higher (CIN2+) via endocervical curettage (ECC) during colposcopy. Methods: Between December 2020 and September 2023, a prospective, cross-sectional study involving women with abnormal cervical cancer screening results who underwent colposcopy was conducted. ECC was performed via a Kevorkian endocervical curette following colposcopy-directed biopsy. The exclusion criteria were glandular cytology abnormalities, pregnancy, post-hysterectomy status, and cervical cancer. Results: The study included 569 women, with a mean age of 41.6 ± 11.7 years. Among the participants, 78.9% presented with low-grade cytology, whereas 21.1% presented with high-grade cytology. All of the patients underwent ECC, with 0.4% (two patients) yielding inadequate samples. ECC detected CIN2+ lesions in 11.6% of the patients (95% confidence interval [CI], 9–14.3). Univariable analysis revealed that age, menopausal status, history of CIN2+, high-grade cytology, and high-grade colposcopy impression were significant factors for CIN2+ detection by ECC. Multivariable analysis confirmed high-grade cytology as the sole independent factor (adjusted odds ratio [OR], 13.81 [95% CI, 4.60–41.42], P < 0.001). ECC added a diagnostic yield of 2.9% (95% CI, 1.5–4.3) for detecting CIN2+ lesions missed by colposcopy-directed biopsy. Multivariable analysis demonstrated an independent association between human papillomavirus 16 (HPV-16) infection and the additional diagnostic benefit of ECC, with an adjusted odds ratio (OR) of 6.26 (95% CI, 1.49–26.23, P = 0.012). Conclusion: This study highlights the critical role of ECC in detecting CIN2+ lesions, particularly in patients with high-grade cytology or HPV-16 positivity.