Comparison of the Cervex-Brush alone to Cytobrush plus Cervex-Brush for detection of cervical dysplasia in women with a transformation zone type 3.
Cytopathology
; 30(2): 157-163, 2019 03.
Article
en En
| MEDLINE
| ID: mdl-30414286
ABSTRACT
INTRODUCTION:
Twenty percent of colposcopic assessments are inadequate due to a type 3 transformation zone (TZ3). In the absence of colposcopic or histological assessment, subsequent management is guided by the referral screening test. In the UK, routine cervical screening is completed by a Cervex-Brush alone. This study examines the effectiveness of a Cytobrush in addition to a standard Cervex-Brush when used in TZ3 assessment.METHODOLOGY:
An 18-month diagnostic accuracy study in a single National Health Service (NHS) Trust. Women with a TZ3 booked for large loop excision of the transformation zone (LLETZ) with a referral cytology of high-risk HPV and squamous dyskaryosis were recruited. Immediately prior to LLETZ, a Cervex-Brush plus Cytobrush liquid-based cytology sample was taken. Presence of endocervical cells was compared. Predictability of high-grade cervical intra-epithelial neoplasia (CIN2+) was by blind standardised reporting of the LLETZ histology.RESULTS:
One hundred and five women were recruited from a total eligible population of 153 cases (68.8%). Endocervical cell yield was increased with the Cervex-Brush plus Cytobrush when compared to the Cervex-Brush alone (99.1% vs 79.1%, P < .001). Irrespective of cytological grade, age or parity, there was no difference in predictability of CIN2+ between sampling methods.CONCLUSIONS:
When compared to Cervex-Brush sampling alone, the addition of a Cytobrush improves endocervical sampling but does not improve cytological predictability of CIN2+ in women with a TZ3. These data suggest that women who will reliably attend for cytological follow-up can be safely referred to primary care for a Cervex-Brush alone.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Displasia del Cuello del Útero
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Citodiagnóstico
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Detección Precoz del Cáncer
Tipo de estudio:
Clinical_trials
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Diagnostic_studies
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Prognostic_studies
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Screening_studies
Límite:
Adult
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Female
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Humans
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Middle aged
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Pregnancy
País/Región como asunto:
Europa
Idioma:
En
Revista:
Cytopathology
Asunto de la revista:
PATOLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Reino Unido