title: Diagnostic value of endocervical curettage for detecting dysplastic lesions in women with atypical squamous cells of undetermined significance (ASC-US) and low grade squamous intraepithelial lesion (LSIL) Papanicolaou smears.
abstract: BACKGROUND
  To determine the frequency of dysplastic lesions in the endocervical curettage (ECC) specimens of women with ASC-US and LSIL Pap and to evaluate the possible factors associated with high grade dysplasia in those ECC specimens.
  
  
  METHODS
  Two hundred and sixty patients with ASC-US and LSIL cytologic smears who underwent an ECC at the time of colposcopic examination during January 2010 and December 2012 were reviewed. Demographic and clinicopathologic data were collected. Multivariate analysis using binary logistic regression was used to identify factors that might be associated with high grade endocervical dysplasia.
  
  
  RESULTS
  The frequency of endocervical dysplasia was 7.7% (20 out of 260 patients). Cervical intraepithelial neoplasia (CIN) 1 and CIN 2-3 lesions in the endocervical canal were observed in 12 and 8 patients, respectively. No microinvasive or invasive cervical cancers were identified. There was no difference in the frequency of high grade endocervical dysplasia between the patients with satisfactory and unsatisfactory colposcopic examinations (1.4% vs 5.1%, respectively, p=0.087). A multivariate logistic regression analysis demonstrated a significant association between high grade CIN on ectocervical biopsy as well as LSIL cytologic smears and high grade dysplasia in endocervical canal (OR=0.046, 95%CI=0.007-0.288; p=0.001 and OR=0.154, 95%CI=0.025-0.942; p=0.043, respectively).
  
  
  CONCLUSIONS
  The frequency of high grade endocervical dysplasia in women with ASC-US and LSIL cytologic smears was low. Therefore, routine performance of ECC in those women is debatable. High grade ectocervical dysplasia and LSIL cytologic smears may be used as predictors for high grade dysplasia in endocervical canal and ECC in these patients is reasonable.
authors.affiliation: Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand E-mail : pyenrudee@gmail.com.
authors.forename: Yenrudee
authors.initials: Y
authors.lastname: Poomtavorn
authors.forename: Komsun
authors.initials: K
authors.lastname: Suwannarurk
authors.forename: Yuthadej
authors.initials: Y
authors.lastname: Thaweekul
authors.forename: Karicha
authors.initials: K
authors.lastname: Maireang
mesh_terms: D000328:Adult; D065309:Atypical Squamous Cells of the Cervix; D002584:Cervix Uteri / Q000473:pathology*; D015331:Cohort Studies; D003127:Colposcopy / Q000379:methods; D003475:Curettage / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D065006:Papanicolaou Test; D012189:Retrospective Studies; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000175:diagnosis / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology*