Value of endocervical curettage in follow-up for patients with cervical intraepithelial neoplasia stage 2+ after loop electrosurgical excision
To assess the value of endocervical curettage (ECC) during follow-up for patients with cervical intraepithelial neoplasia (CIN2+) after loop electrosurgical excision procedures (LEEP) and to explore risk factors for positive ECC during this evaluation. There were 383 CIN2+ patients in the one-step method group who underwent LEEP and were prospectively followed up using ECC as a routine strategy, with colposcopy and liquid-based cytology (LCT) + human papilloma virus (HPV) co-testing performed. The finding were then compared with those from 1041 patients in the retrospective database who underwent colposcopy unless LCT and/or HPV screening was abnormal, and ECC was performed depending on colposcopy images (two-step method group). The two groups were matched using propensity score matching analysis for further statistical comparisons. In total, 383 pairs of patients from both groups were matched. The persistent/recurrent CIN2+ cases were 20 and 21, respectively (P > .05). However, 47 persistent/recurrent CIN1 cases were detected in the one-step method group; this number was significantly higher than that detected in the two-step method group (P < .05). High-risk factors for positive ECC during follow-up included positive ECC before treatment (odds ratio [OR]: 1.670), involved margins (OR: 1.239), and HPV infection and abnormal LCT during follow-up (ORs: 3.130 and 2.637). ECC can detect early recurrent lesions after LEEP in patients with CIN2+ and can offset the limitation of colposcopy and co-testing resulting from LEEP. For patients with positive ECC before LEEP, involved margins, HPV infection, and abnormal LCT after treatment, ECC should be included in the follow-up strategy.