Exploring the applicability criteria of endocervical curettage
Objective To investigate the appropriate conditions for the use of endocervical curettage(ECC).Methods This retrospective study included 3 999 patients from Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science and Technology between January 2021 and May 2023,who had abnormal thinprep cytology test(TCT)results and/or human papillomavirus(HPV)infections.These patients underwent colposcopy-guided multiple cervical biopsies combined with ECC.Postoperative pathological results were used as the gold standard.Retrospective analysis the impact of various factors on ECC pathological outcomes and assessed the clinical applicability of ECC.Results Univariate analysis indicated that age,parity,TCT abnormalities,and specific HPV types(16/18/31/33/52/58)significantly influenced ECC pathological outcomes(P<0.05),while the transformation zone types and menopausal status did not(P>0.05).Logistic regression analysis identified age ≥40,TCT abnormalities,and specific HPV types(16/18/31/33/52/58)as independent risk factors for positive ECC.Multivariate stratified analysis demonstrated that in patients with TCT abnormalities,the ECC positivity rate was significantly higher in the group infected with HPV types(16/18/31/33/52/58)compared to the low-risk or HPV-negative group,regardless of age.Among patients with normal TCT results,those aged ≥40 with HPV16 infection had a significantly higher ECC positivity rate than those under 40.Conclusion ECC is recommended for patients with TCT abnormalities combined with HPV(16/18/31/33/52/58)infections,regardless of age.Additionally,ECC is advisable for patients aged ≥40 with HPV16 infection and normal TCT results.
endocervical curettagecolposcopycervical cancerhuman papillomavirusthinprep cytology test