Lack of Agreement Between Endocervical Brush and Endocervical Curettage in Women Undergoing Repeat Endocervical Sampling
To evaluate agreement between an abnormal endocervical brush (ECB) collected at the time of colposcopy and subsequent endocervical curettage (ECC). All women evaluated for lower genital tract disease at a single academic institution were prospectively entered into a database. The database was querie...
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| Published in: | Journal of lower genital tract disease Vol. 20; no. 4; pp. 296 - 299 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
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United States
01-10-2016
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| Abstract | To evaluate agreement between an abnormal endocervical brush (ECB) collected at the time of colposcopy and subsequent endocervical curettage (ECC).
All women evaluated for lower genital tract disease at a single academic institution were prospectively entered into a database. The database was queried for those who had a colposcopic exam with ECB between April 1, 2013, and June 15, 2015, and who subsequently returned for an ECC to further evaluate eligibility for expectant management or ablative therapy. ECB and ECC results were divided into 2 groups: "low-grade" included low-grade squamous intraepithelial lesions (LSIL) or atypical squamous cells of undetermined significance, and "high-grade" included high-grade squamous intraepithelial lesions (HSIL) or atypical squamous cells-cannot exclude high-grade. Women with atypical glandular cells and unsatisfactory ECB results were excluded. Percent agreement between ECB and ECC was calculated based on these categories.
Seventy-nine women were included: 54 (68%) had a low-grade ECB, and 25 (32%) had a high-grade ECB. Of those who had a low-grade ECB, 4 had a low-grade ECC, 3 had a high-grade ECC, and 47 were negative, resulting in an agreement of 7.4% (4/54). Of those who had a high-grade ECB, 1 had a low-grade ECC, 4 had a high-grade ECC, and 20 were negative, resulting in 16% (4/25) agreement.
Our data suggest that there is poor agreement between ECC and ECB in our patient population. |
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| AbstractList | Objective
To evaluate agreement between an abnormal endocervical brush (ECB) collected at the time of colposcopy and subsequent endocervical curettage (ECC).
Methods
All women evaluated for lower genital tract disease at a single academic institution were prospectively entered into a database. The database was queried for those who had a colposcopic exam with ECB between April 1, 2013, and June 15, 2015, and who subsequently returned for an ECC to further evaluate eligibility for expectant management or ablative therapy. ECB and ECC results were divided into 2 groups: “low-grade” included low-grade squamous intraepithelial lesions (LSIL) or atypical squamous cells of undetermined significance, and “high-grade” included high-grade squamous intraepithelial lesions (HSIL) or atypical squamous cells—cannot exclude high-grade. Women with atypical glandular cells and unsatisfactory ECB results were excluded. Percent agreement between ECB and ECC was calculated based on these categories.
Results
Seventy-nine women were included: 54 (68%) had a low-grade ECB, and 25 (32%) had a high-grade ECB. Of those who had a low-grade ECB, 4 had a low-grade ECC, 3 had a high-grade ECC, and 47 were negative, resulting in an agreement of 7.4% (4/54). Of those who had a high-grade ECB, 1 had a low-grade ECC, 4 had a high-grade ECC, and 20 were negative, resulting in 16% (4/25) agreement.
Conclusions
Our data suggest that there is poor agreement between ECC and ECB in our patient population. To evaluate agreement between an abnormal endocervical brush (ECB) collected at the time of colposcopy and subsequent endocervical curettage (ECC). All women evaluated for lower genital tract disease at a single academic institution were prospectively entered into a database. The database was queried for those who had a colposcopic exam with ECB between April 1, 2013, and June 15, 2015, and who subsequently returned for an ECC to further evaluate eligibility for expectant management or ablative therapy. ECB and ECC results were divided into 2 groups: "low-grade" included low-grade squamous intraepithelial lesions (LSIL) or atypical squamous cells of undetermined significance, and "high-grade" included high-grade squamous intraepithelial lesions (HSIL) or atypical squamous cells-cannot exclude high-grade. Women with atypical glandular cells and unsatisfactory ECB results were excluded. Percent agreement between ECB and ECC was calculated based on these categories. Seventy-nine women were included: 54 (68%) had a low-grade ECB, and 25 (32%) had a high-grade ECB. Of those who had a low-grade ECB, 4 had a low-grade ECC, 3 had a high-grade ECC, and 47 were negative, resulting in an agreement of 7.4% (4/54). Of those who had a high-grade ECB, 1 had a low-grade ECC, 4 had a high-grade ECC, and 20 were negative, resulting in 16% (4/25) agreement. Our data suggest that there is poor agreement between ECC and ECB in our patient population. OBJECTIVETo evaluate agreement between an abnormal endocervical brush (ECB) collected at the time of colposcopy and subsequent endocervical curettage (ECC).METHODSAll women evaluated for lower genital tract disease at a single academic institution were prospectively entered into a database. The database was queried for those who had a colposcopic exam with ECB between April 1, 2013, and June 15, 2015, and who subsequently returned for an ECC to further evaluate eligibility for expectant management or ablative therapy. ECB and ECC results were divided into 2 groups: "low-grade" included low-grade squamous intraepithelial lesions (LSIL) or atypical squamous cells of undetermined significance, and "high-grade" included high-grade squamous intraepithelial lesions (HSIL) or atypical squamous cells-cannot exclude high-grade. Women with atypical glandular cells and unsatisfactory ECB results were excluded. Percent agreement between ECB and ECC was calculated based on these categories.RESULTSSeventy-nine women were included: 54 (68%) had a low-grade ECB, and 25 (32%) had a high-grade ECB. Of those who had a low-grade ECB, 4 had a low-grade ECC, 3 had a high-grade ECC, and 47 were negative, resulting in an agreement of 7.4% (4/54). Of those who had a high-grade ECB, 1 had a low-grade ECC, 4 had a high-grade ECC, and 20 were negative, resulting in 16% (4/25) agreement.CONCLUSIONSOur data suggest that there is poor agreement between ECC and ECB in our patient population. |
| Author | Mazzoni, Sara E Doo, David W Alston, Meredith J Stickrath, Elaine H |
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| References_xml | – volume: 78 start-page: 440 year: 1991 ident: bib10-20231016 article-title: Improving the Cytobrush as an aid in the evaluation of the abnormal Papanicolaou test publication-title: Obstet Gynecol – volume: 16 start-page: 175 year: 2012 ident: bib1-20231016 article-title: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer publication-title: J Low Genit Tract Dis doi: 10.1097/LGT.0b013e31824ca9d5 – volume: 33 start-page: 677 year: 1988 ident: bib5-20231016 article-title: Endocervical brush cytology. An alternative to endocervical curettage? publication-title: J Reprod Med – volume: 82 start-page: 573 year: 1993 ident: bib9-20231016 article-title: Evaluation of the cervical canal with the endocervical brush publication-title: Obstet Gynecol – volume: 17 start-page: S1 issue: 5 suppl 1 year: 2013 ident: bib14-20231016 article-title: 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors publication-title: J Low Genit Tract Dis – volume: 96 start-page: 90 year: 2000 ident: bib7-20231016 article-title: Comparison of endocervical curettage and endocervical brushing publication-title: Obstet Gynecol – volume: 95 start-page: 1336 year: 2003 ident: bib15-20231016 article-title: Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia publication-title: J Natl Cancer Inst doi: 10.1093/jnci/djg037 – volume: 76 start-page: 69 year: 1997 ident: bib3-20231016 article-title: Cytobrush and endocervical curettage in the diagnosis of dysplasia and malignancy of the uterine cervix publication-title: Acta Obstet Gynecol Scand doi: 10.3109/00016349709047788 – volume: 101 start-page: 426 year: 2003 ident: bib4-20231016 article-title: A randomized trial of the sleeved cytobrush and the endocervical curette publication-title: Obstet Gynecol – volume: 99 start-page: S4 year: 2002 ident: bib2-20231016 article-title: A prospective randomized comparison of the endocervical brush and endocervical curette publication-title: Obstet Gynecol – volume: 4 start-page: 76 year: 2000 ident: bib8-20231016 article-title: Comparing endocervical curettage and endocervical brush at colposcopy publication-title: J Low Genit Tract Dis doi: 10.1097/00128360-200004020-00003 – volume: 123 start-page: 1339 year: 2014 ident: bib12-20231016 article-title: Treatment of cervical precancers: back to basics publication-title: Obstet Gynecol doi: 10.1097/AOG.0000000000000287 – volume: 16 start-page: 205 year: 2012 ident: bib13-20231016 article-title: The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: Background and Consensus Recommendations From the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology publication-title: J Low Genit Tract Dis doi: 10.1097/LGT.0b013e31825c31dd – volume: 367 start-page: 489 year: 2006 ident: bib11-20231016 article-title: Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis publication-title: Lancet doi: 10.1016/S0140-6736(06)68181-6 – volume: 159 start-page: 702 year: 1988 ident: bib6-20231016 article-title: Sensitivity and specificity of endocervical curettage and the endocervical brush for the evaluation of the endocervical canal publication-title: Am J Obstet Gynecol doi: 10.1016/S0002-9378(88)80038-3 |
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All women... Objective To evaluate agreement between an abnormal endocervical brush (ECB) collected at the time of colposcopy and subsequent endocervical curettage (ECC).... OBJECTIVETo evaluate agreement between an abnormal endocervical brush (ECB) collected at the time of colposcopy and subsequent endocervical curettage... |
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| SubjectTerms | Adult Cervix Uteri - pathology Female Humans Middle Aged Pathology, Clinical - methods Prospective Studies Specimen Handling - methods Uterine Cervical Neoplasms - diagnosis |
| Title | Lack of Agreement Between Endocervical Brush and Endocervical Curettage in Women Undergoing Repeat Endocervical Sampling |
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