Comparison of the endocervical brush and the endocervical curettage for the evaluation of the endocervical canal.
OBJECTIVE
To evaluate and compare the efficacy in obtaining an adequate endocervical sampling using the endocervical brush and the endocervical curettage.


METHODS
Analysis of the cytology and histology of samples obtained from patients referred to the University of Puerto Rico School of Medicine Tertiary Care Center Anaplasia Clinics for colposcopy due to an abnormal Pap smear having atypical cells or higher as classified according to the Bethesda System. All patients underwent evaluation of the endocervical canal with an endocervical brush and an endocervical curettage.


RESULTS
Fifty three of fifty-eight patients had correlating endocervical brush Papanicolaou smear and endocervical curettage. Only five patients presented discrepancies. All endocervical brush samples had sufficient tissue for diagnosis.


CONCLUSIONS
The endocervical curettage is operator dependent, is difficult to perform in patients with a stenotic cervical os or in menopausal patients. The endocervical brush is easier to use, malleable and has a lower processing cost. In view of these findings evaluation of the endocervix can be safely performed with the use of an endocervical brush. When used properly, the endocervical brush has a sensitivity of 90%, a specificity of 92.1% and a positive predictive value of 87.5%.
Martin
D
D
Department of Obstetrics and Gynecology, University of Puerto Rico, San Juan 00936-5067.
Umpierre
S A
SA
Villamarzo
G
G
Sánchez
O
O
Sánchez
J
J
Carrodeguas
J
J
Adamsons
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D003127:Colposcopy; D003475:Curettage; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D002577:Uterine Cervical Diseases / Q000175:diagnosis*; D014626:Vaginal Smears / Q000295:instrumentation* / Q000379:methods