Hoffman M S, Sterghos S, Gordy L W, Gunasekaran S, Cavanagh D
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa General Hospital.
Obstet Gynecol. 1993 Oct;82(4 Pt 1):573-7.
To evaluate and compare the cytologic information obtained from the endocervical brush and the histologic information obtained from the standard endocervical curettage (ECC) used to evaluate the endocervical canal in patients with an abnormal Papanicolaou test.
Three hundred eighty-eight patients underwent evaluation of an abnormal Papanicolaou test with a repeat Papanicolaou test, a separate endocervical brush test, colposcopy, directed biopsies, and ECC. The study group comprised 101 patients who subsequently underwent conization and/or hysterectomy. The brush and ECC results were evaluated against the final pathologic findings.
Sixty-five patients had a satisfactory colposcopy and 36 had an unsatisfactory colposcopy. Results for these two groups are reported separately. For the total group, the sensitivities of the ECC and brush were 49 and 93%, respectively (P < .001); the specificities were 82 and 26% (P < .001), the positive predictive values were 69 and 52% (P = .99), and the negative predictive values were 65 and 82% (P = .004).
The endocervical brush appears to be a sensitive test for disease in the endocervical canal but yields a high false-positive rate. The role of the brush in this setting will require further study. The ECC is more specific but is also a suboptimal test for identifying disease in the endocervical canal.
评估并比较从子宫颈刷检获得的细胞学信息与从用于评估巴氏试验异常患者子宫颈管的标准子宫颈刮除术（ECC）获得的组织学信息。
388例患者接受了重复巴氏试验、单独的子宫颈刷检、阴道镜检查、定向活检和ECC，以评估异常巴氏试验。研究组包括101例随后接受锥切术和/或子宫切除术的患者。将刷检和ECC结果与最终病理结果进行对照评估。
65例患者阴道镜检查结果满意，36例患者阴道镜检查结果不满意。这两组的结果分别报告。对于整个研究组，ECC和刷检的敏感性分别为49%和93%（P <.001）；特异性分别为82%和26%（P <.001），阳性预测值分别为69%和52%（P =.99），阴性预测值分别为65%和82%（P =.004）。
子宫颈刷检似乎是检测子宫颈管疾病的一项敏感检查，但假阳性率较高。在这种情况下刷检的作用需要进一步研究。ECC特异性更强，但也是用于识别子宫颈管疾病的次优检查。
