评估阴道镜检查中用于检测宫颈上皮内病变的宫颈内口刮除术(ECC)。

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2024-10-29 DOI:10.1007/s00404-024-07721-w
Annika S Behrens, Anna K Dietl, Werner Adler, Carol Geppert, Arndt Hartmann, Antje Knöll, Matthias W Beckmann, Grit Mehlhorn, Martin C Koch, Carla E Schulmeyer, A Seibold, Paul Gass, Frederik A Stuebs
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引用次数: 0

摘要

目的:阴道镜检查的诊断难题主要出现在 50 岁或以上、绝经后和 3 型转化区(TZ3)的妇女身上。宫颈内口刮宫术(ECC)是诊断宫颈内病变的重要工具。这项回顾性分析旨在评估阴道镜检查中使用 ECC 检测宫颈上皮内病变的情况:方法:对2016年7月至2023年6月期间在埃尔兰根大学医院经认证的发育不良科进行的阴道镜检查进行了回顾性研究。巴氏试验和人类乳头瘤病毒(HPV)结果与检查或手术期间通过 ECC 获得的组织学结果相关联。主要结果是阴道镜和组织学结果在细胞学、患者年龄和转化区(TZ)类型方面的准确率:最终分析共纳入了 413 名妇女的 429 次阴道镜检查和通过 ECC 获得的组织学样本。共有 355 名妇女患有 TZ3。在 TZ3 患者中,细胞学检查正常或低度异常的妇女也发现了高级别病变和浸润性癌的证据。在阴道镜检查结果正常的患者中,发现宫颈上皮内瘤变(CIN)2 和 CIN 3/原位癌(AIS)的患者有 56 人(16%),发现浸润癌的患者有 4 人(0.1%):这项分析表明,ECC 是诊断宫颈上皮内瘤变的重要工具,尤其是对于阴道镜检查宫颈和阴道正常,但细胞学结果反复异常或高级别异常细胞学显示为 CIN 2 + 的患者。
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Evaluation of endocervical curettage (ECC) in colposcopy for detecting cervical intraepithelial lesions.

Purpose: Diagnostic challenges in colposcopy arise especially in women aged 50 or older, with postmenopausal status and transformation zone type 3 (TZ3). Endocervical curettage (ECC) is a valuable tool for diagnosing intracervical lesions. The aim of this retrospective analysis was to evaluate the use of ECC in colposcopy for detecting cervical intraepithelial lesions.

Methods: A retrospective study was carried out of colposcopies performed in the certified Dysplasia Unit at Erlangen University Hospital between July 2016 and June 2023. Pap and human papillomavirus (HPV) results were correlated with the histologic findings via ECC, obtained during examinations or surgery. The primary outcome was the rate of accuracy between the colposcopic and histologic findings with regard to cytology, age of patients, and type of transformation zone (TZ).

Results: A total of 429 colposcopies in 413 women with histologic samples obtained via ECC were included in the final analysis. In all, 355 women had TZ3. Among patients with TZ3, evidence of high-grade lesions and invasive carcinoma was also found in women with normal or low-grade abnormal cytology. For patients with normal colposcopic findings, cervical intraepithelial neoplasia (CIN) 2 and CIN 3/adenocarcinoma in situ (AIS) were found in 56 patients (16%), and invasive carcinoma was found in four patients (0.1%).

Conclusion: This analysis suggests that ECC is a valuable tool in the diagnosis of cervical intraepithelial neoplasia, especially for patients who present with a normal colposcopy of the cervix and vagina but have either recurrent abnormal cytologic findings or high-grade abnormal cytology indicating CIN 2 + .

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来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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