Oyer R, Hanjani P
Gynecol Oncol. 1986 Oct;25(2):204-11. doi: 10.1016/0090-8258(86)90100-9.
Routine endocervical curettage has been advocated in the colposcopic evaluation of patients with abnormal cervical cytology. To assess the usefulness of this procedure, we reviewed the records of 518 patients referred to the Colposcopy Clinic with abnormal Pap smears. Data was reviewed retrospectively in 411 patients and collected prospectively in 107 patients. Dysplasia was present in 1.4% of ECC specimens obtained in patients with conclusive colposcopic examinations, and in 25.7% of specimens in patients with inconclusive examinations. Invasive cancer was not detected in any ECC specimen. Eighty patients with inconclusive colposcopic examinations underwent conization of the cervix; in this group, the final pathologic diagnosis was CIN III in 51.2%, microinvasive cancer in 2.5%, and invasive cancer in 1.2%. In patients with conclusive colposcopic examinations, the final pathologic diagnosis was CIN III in 17.2%, and no cases of microinvasive or invasive cancer were present. When the colposcopic examination is conclusive, the incidence of positive ECC is low and may not warrant performing ECC in all patients. When the examination is inconclusive, ECC rarely obviates the need for diagnostic conization as ECC rarely yields a diagnosis of invasive cancer.
对于宫颈细胞学异常的患者进行阴道镜评估时，有人主张进行常规宫颈管刮术。为评估该操作的实用性，我们回顾了518例因巴氏涂片异常转诊至阴道镜诊所的患者记录。对411例患者的数据进行了回顾性分析，对107例患者的数据进行了前瞻性收集。在阴道镜检查明确的患者所获取的宫颈管刮术标本中，发育异常的发生率为1.4%，在检查不明确的患者标本中为25.7%。在任何宫颈管刮术标本中均未检测到浸润癌。80例阴道镜检查不明确的患者接受了宫颈锥切术；在该组中，最终病理诊断为CIN III的占51.2%，微浸润癌的占2.5%，浸润癌的占1.2%。在阴道镜检查明确的患者中，最终病理诊断为CIN III的占17.2%，无微浸润或浸润癌病例。当阴道镜检查明确时，宫颈管刮术阳性的发生率较低，可能并非所有患者都需要进行宫颈管刮术。当检查不明确时，宫颈管刮术很少能避免诊断性锥切术的需要，因为宫颈管刮术很少能得出浸润癌的诊断。
