Risk Factors of Positive Endocervical Curettage and Predictive Model Construction Based on Primary Human Papillomavirus Screening

Introduction The utility and application of endocervical curettage (ECC) during colposcopy remain controversial. This study optimized ECC application for primary human papillomavirus (HPV) screening in patients with high-risk (HR)-HPV. Methods This retrospective study included patients with HR-HPV,...

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Main Authors: Hangjing Gao MS, Guanxiang Huang MS, Binhua Dong MS, Ye Li MS, Hongning Cai MD, Xianqian Chen MS, Tingting Jiang MS, Kelvin Stefan Osafo MS, Dabin Liu MS, Jiancui Chen MS, Huihua Ge MS, Diling Pan MS, Huifeng Xue MS, Pengming Sun PhD, MD
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Technology in Cancer Research & Treatment
Online Access:https://doi.org/10.1177/15330338241312573
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author Hangjing Gao MS
Guanxiang Huang MS
Binhua Dong MS
Ye Li MS
Hongning Cai MD
Xianqian Chen MS
Tingting Jiang MS
Kelvin Stefan Osafo MS
Dabin Liu MS
Jiancui Chen MS
Huihua Ge MS
Diling Pan MS
Huifeng Xue MS
Pengming Sun PhD, MD
author_facet Hangjing Gao MS
Guanxiang Huang MS
Binhua Dong MS
Ye Li MS
Hongning Cai MD
Xianqian Chen MS
Tingting Jiang MS
Kelvin Stefan Osafo MS
Dabin Liu MS
Jiancui Chen MS
Huihua Ge MS
Diling Pan MS
Huifeng Xue MS
Pengming Sun PhD, MD
author_sort Hangjing Gao MS
collection DOAJ
description Introduction The utility and application of endocervical curettage (ECC) during colposcopy remain controversial. This study optimized ECC application for primary human papillomavirus (HPV) screening in patients with high-risk (HR)-HPV. Methods This retrospective study included patients with HR-HPV, who underwent subsequent cervical biopsy and ECC from January 1, 2014, to December 31, 2020. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). The prediction model was presented as a nomogram and evaluated for discrimination and calibration. Results The additional detection rate of cervical intraepithelial neoplasia 2 + lesions with ECC was 2.0% (77/3887) in patients with HR-HPV. In multivariate risk factor analysis, HPV 16 infection presented a high risk of positive ECC, followed by HPV 33, HPV 58, and HPV 31. Irrespective of the abnormal cytopathological results, positive ECC was significantly increased (all P  < .001). Females with acetowhite changes on colposcopy, transformation zone (TZ) type II, TZ type III, colposcopic impression of high-grade squamous intraepithelial lesion, or cancer were at a high risk of positive ECC. The final prediction model included significant variables from risk factor analysis, and had excellent calibration and classification capabilities, with an area under the receiver operating curve of 0.902 (95% CI, 0.881-0.922). Additionally, calibration analysis suggested consistency. Conclusion As the additional detection value of ECC is limited. A satisfactory prediction model was designed to optimize ECC application in patients with HR-HPV infection.
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series Technology in Cancer Research & Treatment
spelling doaj-art-819b7a6fd87f47c0a9c8e48414096dbd2025-08-20T02:51:34ZengSAGE PublishingTechnology in Cancer Research & Treatment1533-03382025-03-012410.1177/15330338241312573Risk Factors of Positive Endocervical Curettage and Predictive Model Construction Based on Primary Human Papillomavirus ScreeningHangjing Gao MS0Guanxiang Huang MS1Binhua Dong MS2Ye Li MS3Hongning Cai MD4Xianqian Chen MS5Tingting Jiang MS6Kelvin Stefan Osafo MS7Dabin Liu MS8Jiancui Chen MS9Huihua Ge MS10Diling Pan MS11Huifeng Xue MS12Pengming Sun PhD, MD13 Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China Fujian Clinical Research Center for Gynecologial Oncology, , Fuzhou, China Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China Department of Gynecology Maternal and Child Health, Hospital of Hubei Province (Women and Children's Hospital of Hubei Province), Wuhan, China Department of Gynecology, The First Hospital of Putian City, Putian, China Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China Fujian Clinical Research Center for Gynecologial Oncology, , Fuzhou, China Fujian Provincial Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, Fuzhou, China Department of Gynecology, The Maternal and Child Health Hospital of Jianou, Nanping, China Department of Pathology, Fujian Maternity and Child Health Hospital, Fuzhou, China Fujian Provincial Cervical Disease Diagnosis and Treatment Health Center, Fujian Maternity and Child Health Hospital, Fuzhou, China Fujian Clinical Research Center for Gynecologial Oncology, , Fuzhou, ChinaIntroduction The utility and application of endocervical curettage (ECC) during colposcopy remain controversial. This study optimized ECC application for primary human papillomavirus (HPV) screening in patients with high-risk (HR)-HPV. Methods This retrospective study included patients with HR-HPV, who underwent subsequent cervical biopsy and ECC from January 1, 2014, to December 31, 2020. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs). The prediction model was presented as a nomogram and evaluated for discrimination and calibration. Results The additional detection rate of cervical intraepithelial neoplasia 2 + lesions with ECC was 2.0% (77/3887) in patients with HR-HPV. In multivariate risk factor analysis, HPV 16 infection presented a high risk of positive ECC, followed by HPV 33, HPV 58, and HPV 31. Irrespective of the abnormal cytopathological results, positive ECC was significantly increased (all P  < .001). Females with acetowhite changes on colposcopy, transformation zone (TZ) type II, TZ type III, colposcopic impression of high-grade squamous intraepithelial lesion, or cancer were at a high risk of positive ECC. The final prediction model included significant variables from risk factor analysis, and had excellent calibration and classification capabilities, with an area under the receiver operating curve of 0.902 (95% CI, 0.881-0.922). Additionally, calibration analysis suggested consistency. Conclusion As the additional detection value of ECC is limited. A satisfactory prediction model was designed to optimize ECC application in patients with HR-HPV infection.https://doi.org/10.1177/15330338241312573
spellingShingle Hangjing Gao MS
Guanxiang Huang MS
Binhua Dong MS
Ye Li MS
Hongning Cai MD
Xianqian Chen MS
Tingting Jiang MS
Kelvin Stefan Osafo MS
Dabin Liu MS
Jiancui Chen MS
Huihua Ge MS
Diling Pan MS
Huifeng Xue MS
Pengming Sun PhD, MD
Risk Factors of Positive Endocervical Curettage and Predictive Model Construction Based on Primary Human Papillomavirus Screening
Technology in Cancer Research & Treatment
title Risk Factors of Positive Endocervical Curettage and Predictive Model Construction Based on Primary Human Papillomavirus Screening
title_full Risk Factors of Positive Endocervical Curettage and Predictive Model Construction Based on Primary Human Papillomavirus Screening
title_fullStr Risk Factors of Positive Endocervical Curettage and Predictive Model Construction Based on Primary Human Papillomavirus Screening
title_full_unstemmed Risk Factors of Positive Endocervical Curettage and Predictive Model Construction Based on Primary Human Papillomavirus Screening
title_short Risk Factors of Positive Endocervical Curettage and Predictive Model Construction Based on Primary Human Papillomavirus Screening
title_sort risk factors of positive endocervical curettage and predictive model construction based on primary human papillomavirus screening
url https://doi.org/10.1177/15330338241312573
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