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Development and validation of a predictive model for endocervical curettage in patients referred for colposcopy:A multicenter retrospective diagnostic study in China

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Chinese Journal of Cancer Research 2022年第4期34卷 395-405页

作者： Peng Xue Bingrui Wei Samuel Seery Qing Li Zichen Ye Yu Jiang Youlin Qiao Department of Epidemiology and Biostatistics School of Population Medicine and Public HealthChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Faculty of Health and Medicine Division of Health ResearchLancaster UniversityLancasterLA14YWUnited Kingdom Diagnosis and Treatment for Cervical Lesions Center Shenzhen Maternity and Child Healthcare HospitalShenzhen 518028China

Objective:This study aimed to develop a nomogram that can predict occult high-grade squamous intraepithelial lesions or worse(HSIL+)and determine the need for endocervical curettage(ECC)in patients referred for colposcopy.Methods:This retrospective multicenter study included 4,149 patients who were referred to any one of six tertiary hospitals in China for colposcopy between January 2020 and November 2021 because of abnormal screening results.ECC data were extracted from the medical records.Univariate and multivariate logistic regression analyses were performed to identify factors that could predict HSIL+on ECC.Patients were randomly assigned to a training set or to an internal validation set for performance and comparability testing.The model was externally validated and tested in patients from two additional hospitals.The nomogram was assessed in terms of discrimination and calibration and subjected to decision curve analysis.Results:HSIL+was found on ECC in 38.8%(n=388)of cases.Our predictive nomogram included age group,cytology,human papillomavirus(HPV)status,visibility of the cervix and colposcopic impression.The nomogram had good overall discrimination,which was internally validated[area under the receiver-operator characteristic(AUC),0.839;95%confidence interval(95%CI),0.773-0.904].In terms of external validation,the AUC was 0.843(95%CI,0.773-0.912)for the consecutive sample and 0.843(95%CI,0.783-0.902)for the comparative sample.Calibration analysis suggested good consistency between predicted and observed probabilities.Decision curve analysis suggested this nomogram would be clinically useful with almost the entire range of threshold probabilities.Conclusions:This internally and externally validated nomogram can be easily applied and incorporates multiple clinically relevant variables that can be used to identify patients with occult HSIL+who need ECC.

关键词： Cervical cancer colposcopy endocervical curettage nomogram

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The Importance of endocervical curettage in an Old Post-Loop Electrosurgical Excision Procedure Woman with Abnormal Cervical Cytology and a Normal Punch Biopsy Histology:A Case Report and Literature Review

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Reproductive and Developmental Medicine 2019年第3期3卷 191-193页

作者： Luo-Pei Guo Qing Cong Hao Zhang Long Sui Medical Center of Diagnosis and Treatment for Cervical Diseases Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200011China Department of Pathology Obstetrics and Gynecology Hospital of Fudan UniversityShanghai 200011China Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases Fudan UniversityShanghai 200011China

endocervical curettage(ECC)is an optional practice during colposcopy,and the indication for endocervical curettage(ECC)is controversial between Europe and the USA.Here,we explored the value of ECC in a specific situation.An elderly post-loop electrosurgical excision procedure woman,who had undergone a colposcopy 4 months before,went for her follow-up and abnormal cytology was found,and both the ECC and punch biopsy showed negative results.Then,a second ECC was performed,which led to the diagnosis of a high-grade squamous intraepithelial lesion.This case report shows that ECC is useful for diagnosing elderly women with Type 3 squamocolumnar junction.

关键词： endocervical curettage High-Grade Squamous Intraepithelial Lesion Loop Electrosurgical Excision Procedure

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