# name
Endocervical Brush Cytology After Cervical Conization as a Predictor of Treatment Failure: A Prospective Cohort Study

# metadata.dc.description.abstract[].value
Objective 
Endocervical curettage (ECC) is the gold standard for predicting the persistence of high-grade squamous intraepithelial lesions (HSIL) after cervical conization. However, ECC has a high rate of unsatisfactory samples and may be uncomfortable for women. Endocervical sampling with brush (ECB) has been proposed as an alternative to ECC, which, in addition to the cytological evaluation, allows performing HPV testing using the same sample. The authors compared ECC and ECB performed immediately after conization to identify women with persistent HSIL.

Materials and Methods 
This is a prospective single-center study, including 518 patients who underwent conization over a 10-year period (2012–2021). Immediately after treatment conization, the authors performed ECB sampling followed by ECC to all patients. They evaluated the accuracy of the 2 techniques for diagnosing persistent HSIL during follow-up.

Results 
Persistent HSIL was identified in 8.9% of women. Eighteen percent of the ECC samples and only 7% of ECB cytology were unsatisfactory (p < .001). The accuracy of detecting persistent HSIL was similar for ECB and ECC (89.0%, 95% CI = 85.9–91.5 vs 90.8%, 95% CI = 87.7–93.2; p = .797). Adding HPV testing to ECB cytological evaluation increased the accuracy to 91.5% (95% CI = 88.8–93.6).

Conclusions 
ECB can be reliably used to identify women with persistent HSIL after conization, as its accuracy is similar to ECC, with a lower rate of unsatisfactory results. The technique allows adding HPV testing to cytological evaluation, improving the accuracy of the test.

# metadata.dc.publisher[].value
Lippincott, Williams & Wilkins. Wolters Kluwer Health

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Journal of Lower Genital Tract Disease, 2025, vol. 29, num.1, p. 42-47

# metadata.dc.rights[].value
(c) American Society for Colposcopy and Cervical Pathology (ASCCP), 2025

# metadata.dc.source[].value
Articles publicats en revistes (Fonaments Clínics)

# metadata.dc.title[].value
Endocervical Brush Cytology After Cervical Conization as a Predictor of Treatment Failure: A Prospective Cohort Study