Kapila Kusum, George Sara S, Al-Shaheen Azza, Al-Ottibi M S, Pathan Shahed K, Sheikh Zafar A, Haji Bahiya E, Mallik Mrinmay K, Das Dilip K, Francis Issam M
Department of Pathology, Faculty of Medicine, Kuwait University.
Med Princ Pract. 2006;15(4):253-9. doi: 10.1159/000092986.
The aim of this study was to determine the incidence of squamous cell abnormalities in cervical cytology in Mubarak Al-Kabeer Hospital, Kuwait, and to document any change in the pattern of these lesions.
Over a 13-year period (1992-2004), 86,434 cervical smears were studied in Mubarak Al-Kabeer Hospital, Kuwait. Conventional Pap smears were first examined by cytotechnicians and finally reported by cytopathologists. The smears were classified according to the modified Bethesda system. The age of presentation of squamous cell abnormalities in Kuwaiti women was analyzed.
Smears from 83,052 (96.09%) patients were found satisfactory for reporting while the remaining 3.9% was unsatisfactory. Atypical squamous cells of undetermined significance (ASCUS) were seen in 1,790 (2.2%) cases, atypical glandular cells of undetermined significance (AGUS) in 630 (0.8%) cases, low grade squamous intraepithelial lesion including human papillomavirus changes (LSIL) in 824 (1.0%) cases, high grade squamous intraepithelial lesion (HSIL) in 189 (0.2%) cases, and carcinoma in 79 (0.1%) cases of which 44 (0.05%) were squamous cell carcinoma. A comparison of average cases/annum during the study period revealed a significant increase in ASCUS from 1.13 to 2.83% (p < 0.001) and AGUS from 0.33 to 1.08% (p < 0.001). However, the percentage of LSIL, HSIL and carcinoma detected in Pap smears remained the same.
A significant linear trend (p < 0.001) was observed in satisfactory smears, ASCUS and AGUS over the years. However, no significant change was found in the detection of LSIL, HSIL and carcinoma. A reduction in the age of LSIL/HSIL and an increasing trend in the number of Kuwaiti women over the years was also observed which makes screening of young women essential in Kuwait.
本研究旨在确定科威特穆巴拉克·卡比尔医院宫颈细胞学检查中鳞状细胞异常的发生率，并记录这些病变模式的任何变化。
在13年期间（1992 - 2004年），对科威特穆巴拉克·卡比尔医院的86434份宫颈涂片进行了研究。传统巴氏涂片首先由细胞技术人员检查，最后由细胞病理学家报告。涂片根据改良的贝塞斯达系统进行分类。分析了科威特女性鳞状细胞异常出现的年龄。
发现83052例（96.09%）患者的涂片报告结果满意，其余3.9%不满意。意义不明确的非典型鳞状细胞（ASCUS）见于1790例（2.2%），意义不明确的非典型腺细胞（AGUS）见于630例（0.8%），低级别鳞状上皮内病变包括人乳头瘤病毒改变（LSIL）见于824例（1.0%），高级别鳞状上皮内病变（HSIL）见于189例（0.2%），癌见于79例（0.1%），其中44例（0.05%）为鳞状细胞癌。研究期间每年平均病例数的比较显示，ASCUS从1.13%显著增加至2.83%（p < 0.001），AGUS从0.33%显著增加至1.08%（p < 0.001）。然而，巴氏涂片中检测到的LSIL、HSIL和癌的百分比保持不变。
多年来，在满意涂片、ASCUS和AGUS中观察到显著的线性趋势（p < 0.001）。然而，在LSIL、HSIL和癌的检测中未发现显著变化。还观察到LSIL/HSIL的年龄降低以及科威特女性数量多年来呈上升趋势，这使得在科威特对年轻女性进行筛查至关重要。
