Grainger D A, Roberts D K, Wells M M, Horbelt D V
Am J Obstet Gynecol. 1987 Mar;156(3):625-8. doi: 10.1016/0002-9378(87)90064-0.
Patients with adequate colposcopic examinations and dysplasia on the endocervical curettage specimen usually undergo further diagnostic evaluation. This study evaluated 712 patients and found the frequency of positive endocervical curettage specimens to be 17.6%. Cervical conization or hysterectomy specimens were examined in 66 cases with a positive endocervical curettage. Of these, 69.7% had histologic evidence of discontinuous dysplasia in the endocervical canal. The endocervical curettage specimens were grouped by the percentage of endocervical epithelium that was dysplastic: group 1, less than 10%; group 2, 10% to 50%; group 3, greater than 50%. Confirmed histologic endocervical involvement was 80%, 56%, and 60%, respectively. The involvement of the endocervical canal also increased with increasing grade of cervical intraepithelial neoplasia. Of the 66 cases examined with positive endocervical curettage specimens, 62.1% had grade 3 cervical intraepithelial neoplasia on the ectocervix. Seven patients had positive endocervical margins, with six of these occurring in grade 3 cervical intraepithelial neoplasia lesions. Two unsuspected cases of cervical malignancy were identified by endocervical curettage.
宫颈检查充分且宫颈管刮除术标本存在发育异常的患者通常会接受进一步的诊断评估。本研究对712例患者进行了评估，发现宫颈管刮除术标本阳性的频率为17.6%。对66例宫颈管刮除术阳性的患者的宫颈锥切术或子宫切除术标本进行了检查。其中，69.7%的患者宫颈管内有组织学证据显示发育异常不连续。宫颈管刮除术标本按发育异常的宫颈上皮百分比分组：第1组，小于10%；第2组，10%至50%；第3组，大于50%。经组织学证实的宫颈管受累率分别为80%、56%和60%。宫颈管受累也随着宫颈上皮内瘤变等级的增加而增加。在66例宫颈管刮除术标本阳性的检查病例中，62.1%的患者宫颈外口有3级宫颈上皮内瘤变。7例患者宫颈管切缘阳性，其中6例发生在3级宫颈上皮内瘤变病变中。通过宫颈管刮除术发现了2例未被怀疑的宫颈恶性肿瘤病例。
