Greenspan David L, Cardillo Marina, Davey Diane D, Heller Debra S, Moriarty Ann T
Department of Obstetrics and Gynecology, Maricopa Medical Center, Affiliate of The University of Arizona College of Medicine, Phoenix, 85008, USA.
J Low Genit Tract Dis. 2006 Apr;10(2):111-22. doi: 10.1097/01.lgt.0000210130.01016.ad.
The 2001 Bethesda System for Reporting Cervical Cytology recommends reporting benign exfoliated endometrial cells in women age 40 and older, and a review of the literature supports this recommendation. Stromal cells and histiocytes do not need to be reported. The effect of hormonal therapy on endometrial shedding is reviewed. Clinical information should be provided to the laboratory so that appropriate educational notes can be appended to the cytology report. Benign endometrial cells in premenopausal women in the first half of the cycle are not associated with significant pathology and such women do not need additional evaluation. Significant pathology is also unlikely in the second half of the cycle and evaluation may not be required unless clinically indicated. Initial evaluation of other women with benign endometrial cells may include either endometrial sampling or transvaginal ultrasound. Atypical endometrial cells are associated with a higher rate of significant pathology and should lead to additional evaluation. Additional prospective studies on the management of patients with endometrial cells on Pap tests are needed.
2001年《贝塞斯达宫颈细胞学报告系统》建议报告40岁及以上女性的良性脱落子宫内膜细胞，文献综述支持这一建议。间质细胞和组织细胞无需报告。文中回顾了激素治疗对子宫内膜脱落的影响。应向实验室提供临床信息，以便在细胞学报告中附加适当的说明。绝经前女性在月经周期前半期出现的良性子宫内膜细胞与重大病变无关，此类女性无需进一步评估。在月经周期后半期出现重大病变的可能性也不大，除非有临床指征，否则可能无需评估。对其他出现良性子宫内膜细胞的女性进行初步评估时，可采用子宫内膜取样或经阴道超声检查。非典型子宫内膜细胞与较高的重大病变发生率相关，应进行进一步评估。还需要对巴氏试验中出现子宫内膜细胞的患者管理进行更多前瞻性研究。
