title: Diagnostic accuracy of two endocervical sampling method: randomized controlled trial.
abstract: OBJECTIVE
  To compare the diagnostic accuracy of endocervical curettage (ECC) and endocervical brushing (EB) in patients referred for colposcopic evaluation for low grade squamous intraepithelial lesion.
  
  
  METHODS
  A prospective, randomized, comparative trial was conducted in an Education and Research Hospital, Gynecologic Oncology Clinic. After exclusion of 40 subjects, 208 patients were randomly allocated into ECC (n = 104) and EB (n = 104) groups. A pathologist blinded to the specimen obtaining method evaluated all samples for the primary outcome of sampling adequacy. Secondary outcome measure was pain scores during the sampling was investigated by using visual analogue scale (VAS).
  
  
  RESULTS
  Ten samples from the ECC group (9.6 %) and 12 samples from the brushing group (12 %) contained scanty endocervical specimen (p = 0.09). Evaluating samples for stroma; it was reported that brushing group had a statistically significantly higher percentage of specimens with no stroma (44 %) than ECC group (24 %) (p = 0.003). Mean and standard deviation of VAS scores during the ECC and EB procedures were 2.55 ± 1.12 and 1.99 ± 0.87, respectively (p < 0.001).
  
  
  CONCLUSIONS
  Endocervical brushing was proved to be as accurate with respect to diagnostic yield as ECC but less painful, evaluating the endocervical canal. It can be an alternative for evaluation of the cervical canal pathology in patients with low grade cytologic abnormalities but devoid of the misinterpretation of stromal invasion; ECC should be preferred in patients with a suspicion of invasive disease.
authors.affiliation: Department of Gynecologic Oncology, Haseki Education and Research Hospital, Istanbul, Turkey.
authors.forename: B Pinar Cilesiz
authors.initials: BP
authors.lastname: Goksedef
authors.forename: Murat
authors.initials: M
authors.lastname: Api
authors.forename: Onur
authors.initials: O
authors.lastname: Kaya
authors.forename: Husnu
authors.initials: H
authors.lastname: Gorgen
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tarlaci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Cetin
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000473:pathology* / Q000601:surgery; D003127:Colposcopy; D003475:Curettage / Q000379:methods*; D003584:Cytological Techniques / Q000295:instrumentation; D005260:Female; D006801:Humans; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000473:pathology