The cases reported herein were collected by Dr. Maksem while he was Chief Pathologist at Mercy Medical Center—Des Moines; Des Moines, Iowa
Endocervical curetting vs. endocervical brushing as case finding methods†
Article first published online: 7 APR 2006
Copyright © 2006 Wiley-Liss, Inc.
Volume 34, Issue 5, pages 313–316, May 2006
How to Cite
Maksem, J. A. (2006), Endocervical curetting vs. endocervical brushing as case finding methods. Diagn. Cytopathol., 34: 313–316. doi: 10.1002/dc.20448
- Issue published online: 7 APR 2006
- Article first published online: 7 APR 2006
- Manuscript Accepted: 21 OCT 2005
- Manuscript Received: 24 JUN 2005
- endocervical curetting;
- endocervical brushing;
- liquid based cytology
This paper focuses on the performance of endocervical curettage (ECC) and intensive endocervical brushing (ECB) (comprising two or more brushings of the endocervix with liquid-based cytology and cell-block examination) in the course of colposcopic examination for abnormal gynecological cytology. To assess their relative effectiveness in disease detection, we reviewed the outcomes of 1,824 colposcopic biopsy collections from women who had an index cytology diagnosis of LSIL or higher. Our intent was to gauge the relative success of ECC and ECB as case-finding procedures in relation to (1) the original cytological diagnosis and (2) the highest (most abnormal) histological diagnosis of the colposcopy study. Our purpose was to determine whether ECB could effectively replace ECC. One thousand five hundred and seven cases of LSILs or higher cases included an ECC along with two or more colposcopic biopsies and 317 cases included an ECB. ECBs were collected into a liquid fixative and processed as both cytology and cell-block specimens; whereas, ECCs were processed according to standard histological techniques. We found that intensive ECB recapitulates the highest diagnosis of the colposcopy study about 5–8 times as often as that of ECC. Moreover, when calculating the proportion of positive outcomes, we found that cases examined with biopsy and ECC discovered fewer women with CIN 2 or higher among both LSIL and HSIL index cytologies as compared with those of cases examined with biopsy and ECB (9.2% vs. 16.8% for LSIL and 63.7% vs. 72.2% for HSIL cases); and, more negative outcomes were seen among women evaluated with biopsy plus ECC than those with biopsy plus ECB (11.3% vs. 8.1% for LSIL and 4.7% vs. 1.4% for HSIL cases). Our findings suggest that the colposcopic study is optimized when it is performed in conjunction with ECB as opposed to ECC, and that intensive ECB may be superior to ECC. Diagn. Cytopathol. 2006; 34:313–316. © 2006 Wiley-Liss, Inc.