Diagnostic Accuracy and Sensitivity of Endocervical Brush Sampling Versus Conventional Pap Cytology in Cervical Intraepithelial Neoplasia

Abstract

Background:
Accurate diagnosis of cervical intraepithelial neoplasia (CIN) in the transformation zone is of decisive importance for the prevention of cervical cancer. Evaluating effective methods of sampling material from the endocervical canal remains a relevant task in gynecology.
Objectives: To compare the sensitivity, specificity, and diagnostic value of sampling material with an endocervical brush versus a traditional Papanicolaou smear (Pap test) in the detection of CIN.
Materials and methods: This prospective study included 230 women with abnormal primary screening results. All patients underwent cytological sampling using both methods, followed by colposcopy and histological biopsy (gold standard).
Results: According to histological data, CIN II+ was diagnosed in 68 (29.6%) women. The sensitivity of the endocervical brush in detecting CIN II+ was 89.7%, and specificity was 85.2% (AUC = 0.88). Traditional cytology demonstrated a sensitivity of 72.1% and a specificity of 88.3% (AUC = 0.80; p = 0.004 for sensitivity comparison). Use of the brush reduced the frequency of uninformative smears due to inadequate endocervical cellularity from 11.3% to 2.6% (p < 0.001).
Conclusions: Sampling material from the endocervical canal with a brush provides higher sensitivity and informativeness in the diagnosis of cervical lesions compared to traditional cytology.

Keywords:
Cervical Intraepithelial Neoplasia, CIN, Endocervical Brush, Pap Test, Cytology, Cervix.