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Objective To explore the value of endocervical curettage (ECC) in the detection of high-grade cervical squamous intraepithelial lesion (HSIL). Methods We retrospectively analyzed the clinical features and colposcopical characteristics of 678 female patients with complete clinical data. Results Among 678 cases, 391 cases were confirmed by cervical biopsy only and 7 cases by ECC only (57.67% vs. 1.03%, P < 0.001). ECC checked out 287 HSIL patients (42.33%, including cervical biopsy positive and negative cases) and cervical biopsy checked out 671 HSIL cases (98.97%, including ECC positive and negative cases). There were 68 positive ECC cases in the conversion area of Type 1+Type 2 and 247 positive ECC cases in the conversion area of Type 3(33.33% vs. 52.11%, P < 0.001). The positive rates of ECC in patients≥45 years old and < 45 years old were 145 and 170, respectively (55.13% vs. 40.96%, P < 0.001). Conclusion The cervical biopsy plays a dominant role in the detection of HSIL, and ECC can only be used as a supplement to it. Female patients older than 45 years or with Type 3 transformation zone examined by colposcopy should be concerned with cervical lesions.
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Objective@#To investigate the clinical values of colposcopy and cervical biopsy and/or endocervical curettage (ECC) in the diagnosis of cervical lesion.@*Methods@#Clinical data of 128 cases of cervical lesion diagnosed by Xuzhou Cancer Hospital from January 23, 2014 to October 11, 2016 were collected and retrospectively analyzed, all patients underwent colposcopy and cervical biopsy and/or ECC.@*Results@#Among them, the age between 30 to 50 years old were 70 cases, whose transformation zone types of Ⅰ, Ⅱ and Ⅲ were 28 cases (40.0%), 23 cases (32.9%) and 19 cases (27.1%), respectively. The age older than 50 years were 45 cases, whose transformation zone types of Ⅱ and Ⅲ were 1 case (2.2%) and 44 cases (97.8%), respectively. Among the 128 cases of cervical lesions, diagnostic results of colposcopy showed that the chronic inflammation were 57 cases, cervical intraepithelial neoplasia (CIN)Ⅰwere 35 cases, CINⅡor CINⅡ~Ⅲ were 8 cases, CIN Ⅲ were 5 cases and cervical cancer were 23 cases. Alternatively, the pathological results showed that the chronic inflammation were 81 cases, CINⅠwere 17 cases, CINⅡor CINⅡ~Ⅲ were 7 cases, CIN Ⅲ were 5 cases and cervical cancer were 18 cases, respectively. Among the 81 cases of chronic inflammation diagnosed by pathology, 52 cases (64.2%) were consistent with the diagnostic results of colposcopy. Among the 17 cases of low grade squamous epithelial cell lesion (LSIL) diagnosed by pathology, 10 cases were in agree with the diagnostic results of colposcopy. Among the 12 cases of high-grade squamous epithelial cell lesion (HSIL) diagnosed by pathology, 9 cases were concordant with the diagnostic results of colposcopy. Among the 18 cases of cervical cancer diagnosed by pathology, 17 cases were consistent with the diagnostic results of colposcopy.@*Conclusions@#The type of transformation zone is positively correlated with the age, and it can help to choose biopsy and therapeutic manner. The diagnostic accuracies of HSIL and early stage of cervical cancer by multi-point biopsy of colposcopy and/or ECC are high. The cervical lesions which are difficultly found by direct visualization can be identified by colposcopy, and thus provides objective evidence to determine the therapeutic manner for patients with stage ⅡA of cervical cancer.
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OBJECTIVE: To evaluate the clinicopathologic variables that are important for predicting residual disease after cervical conization in hysterectomy specimens. METHODS: We performed retrospective review of 125 patients who had undergone cervical conization and endocervical curettage followed by subsequent hysterectomy. Pathologic findings of the cone margins, endocervical curettage samples, and residual lesions in the postcone hysterectomy specimens were recorded for analysis. RESULTS: The prevalence rates of positive cone margins increased with higher severity of cervical neoplasia. There was a statistically significant difference in the prevalence of residual disease in hysterectomy specimens between patients with positive endocervical margins on cone biopsy(67.3%) and those with negative margins(11.8%) (p<0.01). Most residual lesions in the postcone hysterectomy specimens were similar to cone pathology, however the possibility of more advanced lesions in the uterus was present in patients with positive cone margins. Residual disease was significantly more frequently found in patients with positive endocervical curettage(82.4%)(p<0.01). Especially, when both the endocervical margin and endocervical curettage were positive, residual disease was present in 25 of 28 (89.3%) hysterectomy specimens. CONCLUSIONS: From these results, we concluded that the status of endocervical margin and endocervical curettage have significant predictive value with respect to the presence or absence of residual disease, and final decision in regard to subsequent management should be based on histologic finding of the cone margins and endocervical curettage as well as the patient's age and desire to retain reproductive capability.