Apgar Barbara S, Zoschnick Lauren, Wright Thomas C
Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Am Fam Physician. 2003 Nov 15;68(10):1992-8.
The 2001 Bethesda System for reporting cervical or vaginal cytologic diagnoses is an incremental change in the uniform terminology introduced in 1988 and revised in 1991. The 2001 Bethesda System includes specific statements about specimen adequacy, general categorization, and interpretation and results. In the adequacy category, "satisfactory" and "unsatisfactory" are retained, but "satisfactory but limited by" is eliminated. The new category of "atypical squamous cells" (ASC) replaces the category of "atypical squamous cells of undetermined significance" (ASCUS) and is divided into qualifiers of (1) ASC of "undetermined significance" (ASC-US) and (2) "cannot exclude high-grade squamous intraepithelial lesion (HSIL)," or (ASC-H). The categories of ASCUS, "favor reactive" and "favor neoplasia" are eliminated. The terminology for low-grade squamous intraepithelial lesions (LSILs) and HSILs remains unchanged. The category of "atypical glandular cells of undetermined significance" (AGUS) is eliminated to avoid confusion with ASCUS and is replaced by the term "atypical glandular cells" (AGC), with attempts to identify whether the origin of the cells is endometrial, endocervical, or unqualified. "Endocervical adenocarcinoma in situ" and "AGC, favor neoplastic" are included as separate AGC categories. The presence of normal or abnormal endometrial cells is to be reported in women who are at least 40 years of age. Educational notes and comments on ancillary testing may be added as appropriate.
2001年《贝塞斯达系统》用于报告宫颈或阴道细胞学诊断，是对1988年引入并于1991年修订的统一术语的渐进式改变。2001年《贝塞斯达系统》包括关于标本充分性、一般分类以及解释和结果的具体说明。在充分性类别中，保留了“满意”和“不满意”，但删除了“满意但受限于”。新的“非典型鳞状细胞”（ASC）类别取代了“意义不明确的非典型鳞状细胞”（ASCUS）类别，并分为以下限定词：（1）“意义不明确”的ASC（ASC-US）和（2）“不能排除高级别鳞状上皮内病变（HSIL）”，即ASC-H。ASCUS、“倾向反应性”和“倾向肿瘤形成”类别被删除。低级别鳞状上皮内病变（LSIL）和HSIL的术语保持不变。“意义不明确的非典型腺细胞”（AGUS）类别被删除以避免与ASCUS混淆，取而代之的是“非典型腺细胞”（AGC）一词，并尝试确定细胞的起源是子宫内膜、宫颈管内膜还是未明确。“宫颈管原位腺癌”和“AGC，倾向肿瘤形成”作为单独的AGC类别包括在内。对于至少40岁的女性，应报告正常或异常子宫内膜细胞的存在。可根据情况酌情添加关于辅助检测的教育性注释和评论。
