35岁以上女性的宫颈发育异常

Cervical dysplasia among women over 35 years of age.

作者信息

Moore Kathleen N, Bannon Ryan J, Lanneau Grainger S, Zuna Rosemary E, Walker Joan L, Gold Michael A

机构信息

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

出版信息

Am J Obstet Gynecol. 2008 Nov;199(5):471.e1-5. doi: 10.1016/j.ajog.2008.03.048. Epub 2008 May 19.

DOI:10.1016/j.ajog.2008.03.048

PMID:18486088

Abstract

OBJECTIVE

The objective of the study was to review the cytologic and histopathologic features among women 35 years of age or older with cervical dysplasia.

STUDY DESIGN

Patients presenting between 2001 and 2005 were included. Patients were labeled as pre- (PRE) or postmenopausal (POST) based on age younger than or 50 years old or older. Statistics were performed using SAS 8.0.

RESULTS

Three hundred fifty-nine patients were identified: 270 PRE and 89 POST. PRE and POST patients had similar referral cytology with atypical cells of undetermined significance (ASC)/low-grade squamous intraepithelial lesion (LSIL) in 60% and 65% and high-grade squamous intraepithelial lesion (HSIL) in 35% and 27%, respectively. Among patients with ASC/LSIL, POST had significantly more cervical intraepithelial neoplasia (CIN) 3 (41% vs 29%; P = .027) as well as more malignancies (17 vs 0%; P = .002). Among patients referred for loop electrical excisional procedure secondary to HSIL cytology not explained by colposcopy, CIN 2 or greater was identified more often in POST (71 vs 32%; P = .03).

CONCLUSION

Our data demonstrate a high proportion of severe cervical dysplasia in age groups traditionally thought to have less risk than younger patients.

摘要

目的

本研究的目的是回顾35岁及以上宫颈发育异常女性的细胞学和组织病理学特征。

研究设计

纳入2001年至2005年间就诊的患者。根据年龄小于或等于50岁或大于50岁，将患者标记为绝经前（PRE）或绝经后（POST）。使用SAS 8.0进行统计分析。

结果

共确定359例患者：270例PRE和89例POST。PRE和POST患者的转诊细胞学结果相似，意义不明确的非典型细胞（ASC）/低级别鳞状上皮内病变（LSIL）分别占60%和65%，高级别鳞状上皮内病变（HSIL）分别占35%和27%。在ASC/LSIL患者中，POST患者的宫颈上皮内瘤变（CIN）3级明显更多（41%对29%；P = 0.027），恶性肿瘤也更多（17例对0例；P = 0.002）。在因HSIL细胞学结果而转诊行环形电切术且阴道镜检查无法解释的患者中，POST患者更常发现CIN 2级或更高级别病变（71%对32%；P = 0.03）。