Evaluating the Benefits of Endocervical Curettage in Women Infected With HPV16/18

Yusha Chen; Suyu Li; Jiancui Chen; Huifeng Xue; Xiangqin Zheng; Diling Pan

doi:10.1097/LGT.0000000000000863

Evaluating the Benefits of Endocervical Curettage in Women Infected With HPV16/18

J Low Genit Tract Dis. 2024 Dec 17. doi: 10.1097/LGT.0000000000000863. Online ahead of print.

Authors

Yusha Chen¹, Suyu Li², Jiancui Chen¹, Huifeng Xue¹, Xiangqin Zheng³, Diling Pan⁴

Affiliations

¹ Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital College of Clinical Medical for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
² Department of Radiation Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medical for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
³ Department of Gynecology, Fujian Maternity and Child Health Hospital College of Clinical Medical for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
⁴ Department of Pathology, Fujian Maternity and Child Health Hospital College of Clinical Medical for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.

PMID: 39688214
DOI: 10.1097/LGT.0000000000000863

Abstract

Objective: This study evaluates the effectiveness of endocervical curettage (ECC) in detecting additional high-grade squamous intraepithelial lesions or worse (HSIL+) in women infected with human papillomavirus (HPV) types 16 and 18, which may be missed by biopsy alone.

Methods: A retrospective cohort study analyzed the medical records of 4,811 women referred for colposcopy due to HPV16/18 infection from January 2019 to December 2023. Patients underwent both biopsy and ECC. Statistical comparisons of various clinical factors between HSIL+ and low-grade or normal lesions were performed using χ2 tests and logistic regression analyses, with stratified analysis to determine ECC's additional detection rate under different clinical conditions.

Results: Endocervical curettage detected an additional 6.46% of HSIL+ lesions missed by biopsy alone, with the highest rates in women with normal colposcopic impressions (23.1%), those aged 50 or older (12%), type 3 transformation zones (9.5%), and postmenopausal women (11.9%). In contrast, younger women under 30 and those with type 1 or 2 transformation zones had significantly lower detection rates (2.9%). Logistic regression indicated that older age, type 3 transformation zone, higher grade cytological results, and abnormal colposcopic impressions are significant risk factors for HSIL+ detection via ECC (p < .001).

Conclusions: Data from this study indicate that ECC would be beneficial for women over 30 with HPV16/18 infections, particularly those with type 3 transformation zones or normal colposcopy, as it enhances HSIL+ detection. However, it offers minimal benefit for younger women or those with type 1 or 2 transformation zones.