Bai H, Sung C J, Steinhoff M M
Department of Pathology, Women and Infants' Hospital of Rhode Island, Brown University School of Medicine, Providence 02905-2401, USA.
Diagn Cytopathol. 2000 Jul;23(1):19-22. doi: 10.1002/1097-0339(200007)23:1<19::AID-DC4>3.0.CO;2-K.
The objectives of this study were to evaluate 1) the detection rate of atypical glandular cells of undetermined significance of endocervical cell type (AGUS-EC) and 2) the correlation between AGUS-EC on cytology and biopsy results using the conventional Papanicolaou (Pap) smear test vs. the ThinPrep Pap test (TPPT). Cervical-vaginal samples processed by the conventional Pap smear for 11 mo in 1996-1997 were identified, as were TPPTs collected for the same interval in 1997-1998. Biopsy results were compared after a 9-mo follow-up for both groups. There were 112 AGUS-EC cases from 82,754 conventional Pap smears (detection rate, 0.14%) compared with 58 cases from 82,252 TPPTs (detection rate, 0.07%) (P < 0.01). Biopsies were available in 72 of 112 patients from the conventional Pap smear group and 35 of 58 patients from the TPPT groups. Five dysplastic glandular lesions/ AIS were diagnosed by biopsy in the 35 patients (14.3%)from the TPPT group, compared with 2 of the 72 patients (2.8%) from the conventional Pap smear group (P < 0.05). There were no statistically significant differences between other follow-up diagnoses for the two methods. The use of TPPT resulted in fewer cases of AGUS-EC and better correlation with histology. The TPPT appears to be as sensitive as and more specific than the conventional Pap smear for detection of endocervical glandular lesions.
1）宫颈管细胞类型意义不明确的非典型腺细胞（AGUS-EC）的检出率；2）使用传统巴氏涂片检查与薄层液基细胞学检测（TPPT）时，AGUS-EC在细胞学检查与活检结果之间的相关性。确定了1996 - 1997年用传统巴氏涂片处理11个月的宫颈-阴道样本，以及1997 - 1998年相同时间段收集的TPPT样本。两组均经过9个月的随访后比较活检结果。在82,754份传统巴氏涂片中发现112例AGUS-EC病例（检出率为0.14%），而在82,252份TPPT中有58例（检出率为0.07%）（P < 0.01）。传统巴氏涂片组112例患者中有72例可获得活检结果，TPPT组58例患者中有35例可获得活检结果。TPPT组35例患者（14.3%）经活检诊断为5例发育异常的腺性病变/原位腺癌（AIS），而传统巴氏涂片组72例患者中有2例（2.8%）（P < 0.05）。两种方法的其他随访诊断之间无统计学显著差异。使用TPPT导致AGUS-EC病例减少，且与组织学的相关性更好。对于宫颈管腺性病变的检测，TPPT似乎与传统巴氏涂片一样敏感，且更具特异性。
