Rossetti D, Gerli S, Saab J C, Di Renzo G C
Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy.
J Med Liban. 2000 May-Jun;48(3):127-30.
A new terminology for cytologic diagnosis of cervical lesions has been introduced by Bethesda System. This includes: 1) Atypical squamous cells of undetermined significance (ASCUS), 2) Low-grade squamous intraepithelial lesion (LSIL), 3) High-grade squamous intraepithelial lesion (HSIL), 4) squamo-cellular carcinoma. The aim of this study was to assess the correlation between the colpocytologic test (Pap psmear), the histologic response and colposcopy.
We re-examined the cytologic results of 447 patients who underwent routine cytologic tests, with a diagnosis of various grades of atypia, from ASCUS to HSIL. A histologic test was carried out on a colposcopic basis in 210 cases and cytologic results were correlated with the histologic and colposcopic pictures.
For ASCUS the histology was positive in 19.1% (31/163) of cases and negative in 10.4% of the colposcopically positive cases (17/163), while in the remaining 70.5% (115/163) the colposcopy resulted negative. In LSIL with the presence of human papillomavirus (HPV) the histologic findings, confirmed the cytologic result in 35.8% (48/134) while in the group of cervical intraepithelial neoplasia (CIN I) results corresponded in 40.6% (41/101). In high squamous intraepithelial lesions there was an histologic confirmation in 59.2% (29/49).
The data obtained indicate an increase in positive histology results from the types of low grade (ASCUS-LSIL) to those of a high grade (HSIL). Our results indicate that the presence of ASCUS should be assessed colposcopically and histologically, where indicated.
贝塞斯达系统引入了一种用于宫颈病变细胞学诊断的新术语。这包括：1）意义不明确的非典型鳞状细胞（ASCUS），2）低级别鳞状上皮内病变（LSIL），3）高级别鳞状上皮内病变（HSIL），4）鳞状细胞癌。本研究的目的是评估阴道镜细胞学检查（巴氏涂片）、组织学结果与阴道镜检查之间的相关性。
我们重新检查了447例接受常规细胞学检查的患者的细胞学结果，这些患者被诊断为从ASCUS到HSIL的各种级别的异型性。在210例病例中进行了基于阴道镜检查的组织学检查，并将细胞学结果与组织学和阴道镜图像进行了关联。
对于ASCUS，组织学检查在19.1%（31/163）的病例中呈阳性，在阴道镜检查阳性的病例中有10.4%（17/163）呈阴性，而在其余70.5%（115/163）的病例中阴道镜检查结果为阴性。在存在人乳头瘤病毒（HPV）的LSIL中，组织学检查结果在35.8%（48/134）的病例中证实了细胞学结果，而在宫颈上皮内瘤变（CIN I）组中，结果相符的比例为40.6%（41/101）。在高级别鳞状上皮内病变中，组织学检查证实的比例为59.2%（29/49）。
获得的数据表明，从低级别（ASCUS-LSIL）到高级别（HSIL）类型的组织学阳性结果有所增加。我们的结果表明，如有指征应通过阴道镜检查和组织学检查来评估ASCUS的存在情况。
