Toki T, Fujii S, Yajima A
Department of Obstetrics and Gynecology, Shinshu University School of Medicine, Matsumoto.
Nihon Sanka Fujinka Gakkai Zasshi. 1994 Mar;46(3):265-70.
Endocervical curettage (ECC) was routinely performed at the time of colposcopy on 200 cases with an abnormal PAP smear. Colposcopically, 77 cases were normal, 99 were abnormal, and 24 were unsatisfactory. Results of the directed biopsies were within normal limits for 84 cases, glandular dysplasia for 2, squamous dysplasia for 95, carcinoma in situ (CIS) for 17, and squamous cell carcinoma for 3. Histologic diagnoses of the ECC specimens were "tissue insufficient for diagnosis" for 11 cases, "benign endocervical tissue" for 167 including 9 squamous metaplasias and 3 cervical polyps, "fragments of dysplasia" for 12, CIS for 6, and squamous carcinoma for 4. Regarding 73 cases who underwent surgical treatment, the biopsy diagnosis had been either false negative in 6 cases or underestimated in 5 cases as compared to the confirmed diagnosis. That is to say, 11 cases might have been diagnosed incorrectly without ECC. The major lesion was located within the endocervix in most of such cases. It is therefore suggested that ECC improves the accuracy of the histologic diagnosis of premalignant and malignant lesions of the cervix and that ECC is an essential procedure especially in endocervical lesions.
对200例巴氏涂片异常的患者在阴道镜检查时常规进行宫颈管搔刮术（ECC）。阴道镜检查结果显示，77例正常，99例异常，24例不满意。直接活检结果显示，84例在正常范围内，2例为腺发育异常，95例为鳞状上皮发育异常，17例为原位癌（CIS），3例为鳞状细胞癌。ECC标本的组织学诊断为：11例“组织不足以诊断”，167例为“良性宫颈管组织”，包括9例鳞状化生和3例宫颈息肉，12例为“发育异常碎片”，6例为CIS，4例为鳞状癌。对于73例接受手术治疗的患者，与确诊诊断相比，活检诊断有6例假阴性，5例低估。也就是说，若不进行ECC，11例可能会被误诊。大多数此类病例的主要病变位于宫颈管内。因此，建议ECC可提高宫颈癌前病变和恶性病变组织学诊断的准确性，并且ECC是一项必不可少的操作，尤其是对于宫颈管病变。
