摘要
目的探讨宫颈不典型鳞状上皮，低度鳞状上皮内病变（ASCUS／LSIL）的临床意义及处理方法。方法对中国医学科学院肿瘤医院2004～2006年妇科门诊用TCT（宫颈液基细胞学）的方法检出的254例ASCUS／LSIL以病理结果为金标准进行回顾性分析，其中136例进行了阴道镜检查。结果在140例ASCUS中，宫颈上皮内瘤变（CIN）病变占51．5％，其中高度病变占22．9％，114例LSIL中CIN病变占59．6％，其中高度病变占30．7％，两组资料比较差异无统计学意义，P〉0．05。其中136例中阴道镜诊断炎症47例，低度宫颈上皮内病变53例，高度宫颈上皮内病变36例及病理检查结果炎症55例，低度宫颈上皮内病变41例，高度宫颈上皮内病变40例，阴道镜与病理对照进行了～致性检验，Kappa=0．314，U=0．064，P〈0．05，一致性好。病理证实人乳头状瘤病毒（HPV）阳性的妇女中CIN发生率79％（67／84），而HPV阴性者中CIN发生率43．5％％（74／170），结果显示两组资料比较差异有统计学意义，X^2=29．88，P〈0．05。本组资料中年龄在35～55岁的妇女占83．5％与HPV阳性的妇女年龄高峰一致。结论对ASCUS的患者应与LSIL同样重视，立即进行阴道镜检查以避免22．9％的高度病变的患者漏诊或失访，对35～55岁的HPV感染的妇女应更加重视。
Objective To investigate the clinical significance and management of ASCUS/LSIL. Methods 254 patients who were examined with cervical cytology in the Cancer Institute ＆ Hospital Chinese Academy of Medical Sciences were ASCUS/LSIL, of whom 136 cases underwent colposcopy, Data were analyzed retrospectively according to the golden criterion of pathology outcome. Results 140 cases were ASCUS, and 114 cases were LSIL. Cervical intra-epithelial neoplasia （CIN） were diagnosed in 51.5% of patients with ASCUS, compared with 59.6% of patients with LSIL（ P 〉 0.05）. High-grade cervical intraepithelial neoplasia were diagnosed in 22.9 % of patients with ASCUS, compared with 30.7 % of patients with LSIL（ P 〉 0.05）. In the 136 patients examined with colposcopry, inflammation was found in 47 cases, low-grade intraepithelial lesion in 53 cases, High-grade intraepithelial lesion in 36 cases. The pathological results show inflammation in 55 cases, low- grade intraepithelial lesion in 41 eases, High-grade intraepithelial lesion in 40 cases（ Kappa = 0. 314, U = 0.064, P 〈 0.05）. CIN were diagnosed in 79% （67/84） of HPV-positive patients identified by pathology, compared with 43.5%（74/170） of HPV-negative patients（X^2 = 29.88, P 〈 0.05）. 83.5% of 254 patients were between 35 to 55 years old, and that was consistent with HPV-positive women age peak. Conclusion Patients with ASCUS should be paid the same attention with LSIL patients and colposcopy examination should be done immediately to avoid missed diagnosis and missed follow-up examination, especially for HPV positive patients between 35 to 55 years old.
出处
《中华实验和临床病毒学杂志》
CAS
CSCD
北大核心
2007年第3期267-269,共3页
Chinese Journal of Experimental and Clinical Virology
关键词
子宫颈
细胞学
肿瘤
鳞状细胞
宫颈上皮内瘤样病变
乳头状瘤病毒
人
组织细胞学制备技术
Cervix
Cytology
Neoplasms, Squamous cell
Cervical intraepithelial neoplasia
Papillomavirus, human
Histocytoloical preparation techniques
