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Diagnostic accuracy of two endocervical sampling method: randomized controlled trial
B Pinar Cilesiz Goksedef1, Murat Api, Onur Kaya
1Department of Gynecologic Oncology, Haseki Education and Research Hospital, Istanbul, Turkey.
Archives of Gynecology and Obstetrics
|September 6, 2012
Summary
Endocervical brushing is as accurate as endocervical curettage for diagnosing cervical abnormalities but causes less pain. This makes endocervical brushing a viable alternative for evaluating cervical canal pathology.
Area of Science:
- Gynecologic Oncology
- Cervical Pathology Diagnostics
Background:
- Low-grade squamous intraepithelial lesions (LSIL) require accurate diagnostic methods.
- Endocervical curettage (ECC) and endocervical brushing (EB) are used for evaluating the endocervical canal.
Purpose of the Study:
- To compare the diagnostic accuracy of ECC and EB.
- To assess pain associated with ECC and EB procedures.
Main Methods:
- Prospective, randomized trial with 208 patients.
- Patients allocated to ECC (n=104) or EB (n=104) groups.
- Pathologist assessed sampling adequacy; Visual Analogue Scale (VAS) measured pain.
Main Results:
- Sampling adequacy was similar between ECC and EB (p=0.09).
- EB showed significantly more specimens without stroma (44%) compared to ECC (24%) (p=0.003).
- EB procedures were significantly less painful (VAS 1.99) than ECC (VAS 2.55) (p < 0.001).
Conclusions:
- Endocervical brushing offers comparable diagnostic yield to ECC.
- EB is a less painful alternative for evaluating cervical canal pathology in LSIL patients.
- ECC remains preferred for suspected invasive disease due to stromal evaluation.
