title: Reliability of Endocervical Curettage in the Diagnosis of High-grade Cervical Neoplasia and Cervical Cancer in Selected Patients.
abstract: OBJECTIVE
  To analyze the reliability of endocervical curettage (ECC) in the diagnosis of high-grade cervical intraepithelial neoplasia and cervical cancer, and to identify risk factors associated with diagnostic underestimation.
  
  
  METHODS
  A retrospective study was carried-out involving 445 patients who underwent ECC for: endocervical lesion incompletely visible on colposcopy or inaccessible to biopsy; atypical glandular cells on smear, or discrepancy between colposcopic impression and cytological abnormalities.
  
  
  RESULTS
  Comparison between ECC and final diagnosis showed a perfect match in 362 patients (81.3%). For 189 patients with pre-cancerous or cancerous endocervical lesions, the sensitivity, specificity, and positive and negative predictive values were 87.3%, 96.9%, 95.4% and 91.9%, respectively. No clinical, cytological or colposcopic characteristics were associated with significantly increased risk of diagnostic underestimation with ECC.
  
  
  CONCLUSIONS
  ECC is a very reliable tool for reducing the number of unnecessary treatments, without increasing the risk of allowing some lesions to evolve into cancer.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Hautepierre, Strasbourg, France.
authors.forename: Cherif
authors.initials: C
authors.lastname: Akladios
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Hautepierre, Strasbourg, France.
authors.forename: Lise
authors.initials: L
authors.lastname: Lecointre
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Hautepierre, Strasbourg, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Baulon
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Hautepierre, Strasbourg, France.
authors.forename: Veronique
authors.initials: V
authors.lastname: Thoma
authors.affiliation: Department of Pathology, University Hospital of Hautepierre, Strasbourg, France.
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Averous
authors.affiliation: EVE Association, Graffenstaden, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Fender
authors.affiliation: Methodology and Biostatistics Sector, Public Health Department, Strasbourg University Hospitals, Strasbourg, France.
authors.forename: François
authors.initials: F
authors.lastname: Lefebvre
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Hautepierre, Strasbourg, France Jean-Jacques.Baldauf@chru-strasbourg.fr.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Baldauf
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery; D003127:Colposcopy / Q000379:methods; D003475:Curettage / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D018579:Patient Selection; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*
keywords: CIN; cervical cancer; colposcopy; endocervical curettage