Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Via Pansini n° 5, 80131, Naples, Italy.
Department of Public Health, University of Naples Federico II, Via Sergio Pansini, Naples, Italy.
Updates Surg. 2022 Aug;74(4):1239-1245. doi: 10.1007/s13304-021-01193-2. Epub 2021 Nov 5.
Endocervicoscopy is an alternative diagnostic tool to endocervical curettage for the diagnostic workup of repeatedly positive cervicovaginal cytology suggestive of a high-grade squamous intraepithelial lesion (HSIL) and negative or unsatisfactory colposcopy. The aim of this review is to summarize the current evidence on the diagnostic accuracy of endocervicoscopy in women with cervical intraepithelial neoplasia in the presence of nonvisible squamocolumnar junction with unsatisfactory colposcopy. A systematic review of literature was performed by searching in the main electronic databases (MEDLINE, EMBASE, Web of Science, Scopus, ClinicalTrial.gov, OVID and Cochrane Library), from their inception to January 2021 for studies testing endocervicoscopy. Risk of Bias Assessment was performed. Four articles were included: three prospective and one retrospective cohort studies. Data on the endocervicoscopy accuracy, the accuracy and reliability correlation with definitive histology, the cone biopsy dimension after endocervicoscopy, the comparison between endocervicoscopy and curettage and the lesion missed were analyzed. Based on our results, the limit of this technique is the low predictive value that does not allow it to replace the colposcopy. Nevertheless, it could help to define the characteristics and localization of cervical-suspected lesions. However, further studies are needed to clarify its use and indication.
阴道镜检查是一种替代宫颈刮片的诊断工具，用于诊断反复出现的宫颈阴道细胞学检查阳性、提示高级别鳞状上皮内病变（HSIL）且阴道镜检查阴性或不满意的患者。本综述的目的是总结在阴道镜检查不满意且未见明显鳞-柱状交界的情况下，阴道镜检查在宫颈上皮内瘤变患者中的诊断准确性的现有证据。通过在主要电子数据库（MEDLINE、EMBASE、Web of Science、Scopus、ClinicalTrial.gov、OVID 和 Cochrane Library）中搜索，从其建立到 2021 年 1 月，对测试阴道镜检查的研究进行了系统的文献回顾。对偏倚风险进行了评估。共纳入 4 篇文章：3 项前瞻性研究和 1 项回顾性队列研究。分析了阴道镜检查的准确性、与明确组织学的准确性和可靠性相关性、阴道镜检查后锥切的大小、阴道镜检查与刮宫的比较以及遗漏病变的数据。根据我们的结果，该技术的局限性在于其预测值较低，不能替代阴道镜检查。然而，它可以帮助确定宫颈可疑病变的特征和定位。但是，需要进一步的研究来阐明其用途和适应证。
