Diagnostic Value of Endocervical Curettage for DetectingDysplastic Lesions in Women with Atypical Squamous Cells of Undetermined Significance (ASC-US) and Low Grade Squamous Intraepithelial Lesion (LSIL) Papanicolaou Smears

Abstract

<b>Background:</b> To determine the frequency of dysplastic lesions in the endocervical curettage (ECC) specimensof women with ASC-US and LSIL Pap and to evaluate the possible factors associated with high grade dysplasia inthose ECC specimens. Materials and <br/><b>Methods</b>: Two hundred and sixty patients with ASC-US and LSIL cytologicsmears who underwent an ECC at the time of colposcopic examination during January 2010 and December2012 were reviewed. Demographic and clinicopathologic data were collected. Multivariate analysis using binarylogistic regression was used to identify factors that might be associated with high grade endocervical dysplasia.<br/><b>Results</b>: The frequency of endocervical dysplasia was 7.7% (20 out of 260 patients). Cervical intraepithelialneoplasia (CIN) 1 and CIN 2-3 lesions in the endocervical canal were observed in 12 and 8 patients, respectively.No microinvasive or invasive cervical cancers were identified. There was no difference in the frequency of highgrade endocervical dysplasia between the patients with satisfactory and unsatisfactory colposcopic examinations(1.4% vs 5.1%, respectively, p=0.087). A multivariate logistic regression analysis demonstrated a significantassociation between high grade CIN on ectocervical biopsy as well as LSIL cytologic smears and high gradedysplasia in endocervical canal (OR=0.046, 95%CI=0.007-0.288; p=0.001 and OR=0.154, 95%CI=0.025-0.942;p=0.043, respectively). <br/><b>Conclusions</b>: The frequency of high grade endocervical dysplasia in women with ASC-USand LSIL cytologic smears was low. Therefore, routine performance of ECC in those women is debatable. Highgrade ectocervical dysplasia and LSIL cytologic smears may be used as predictors for high grade dysplasia inendocervical canal and ECC in these patients is reasonable.