Endocervical sampling using brush versus curette: a single centre experience and literature review

Area of Science:

• Gynecology
• Pathology
• Colposcopy

Background:

• Endocervical sampling is crucial in colposcopy for diagnosing cervical conditions.
• Traditionally, the endocervical curette (ECC) has been used for endocervical sampling.
• The efficacy of the endocervical brush (ECB) compared to ECC for histopathological diagnosis remains unclear.

Approach:

• This study retrospectively reviewed 127 endocervical curette (ECC) and 98 endocervical brush (ECB) samples from patients undergoing colposcopy.
• Histopathological diagnoses were compared between the two sampling methods.
• A literature review was also conducted to contextualize the findings.

Key Points:

• Histopathological diagnosis was achieved in 97.6% of ECC samples and 95.9% of ECB samples (p=0.46).
• The detection rate of high-grade pathologies, when combined with cervical biopsies, was similar between ECC (17.7%) and ECB (17.0%) (p=0.43).
• Both methods showed a high incidence of benign results and acceptable rates of insufficient tissue.

Conclusions:

• Endocervical brush (ECB) and endocervical curette (ECC) exhibit comparable performance in providing histopathological diagnoses from endocervical samples.
• The endocervical brush is an adequate and safe alternative to the curette for colposcopic sampling.
• Clinical practice can consider either method based on clinician preference, with further research exploring patient perspectives.