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非典型鳞状细胞、低度鳞状上皮内病变及宫颈上皮内瘤变1级的管理

Management of atypical squamous cells, low-grade squamous intraepithelial lesions, and cervical intraepithelial neoplasia 1.

作者信息

Boardman Lori A, Kennedy Colleen M

机构信息

University of Central Florida College of Medicine, 12201 Research Parkway, 3rd Floor, Orlando, FL 32816-0116, USA.

出版信息

Obstet Gynecol Clin North Am. 2008 Dec;35(4):599-614; ix. doi: 10.1016/j.ogc.2008.09.001.

Abstract

In the American Society for Colposcopy and Cervical Pathology 2006 Consensus Guidelines, several changes in the management of mildly abnormal cervical cytology and histology were made. The most notable changes involve the management of adolescents, pregnant women, and postmenopausal women. For adolescents, management of atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions is conservative, eliminating the need for immediate colposcopy. For pregnant women, options have been made to allow for deferral of colposcopy until pregnancy completion, whereas for postmenopausal women, the new guidelines call for the option to rely on human papillomavirus DNA testing or repeat cytology to manage mild cytologic abnormalities. The guidelines for cervical intraepithelial neoplasia 1 now focus on conservative management. The goal of this article is to review the 2006 Guidelines, elaborating on the changes and providing the rationale for management decisions.

摘要

在美国阴道镜及宫颈病理学会2006年共识指南中,轻度异常宫颈细胞学和组织学的管理有多项变动。最显著的变动涉及青少年、孕妇和绝经后女性的管理。对于青少年,意义不明确的非典型鳞状细胞和低级别鳞状上皮内病变的管理较为保守,无需立即进行阴道镜检查。对于孕妇,已给出选择,可将阴道镜检查推迟至妊娠结束,而对于绝经后女性,新指南要求可选择依靠人乳头瘤病毒DNA检测或重复细胞学检查来管理轻度细胞学异常。宫颈上皮内瘤变1级的指南现在侧重于保守管理。本文的目的是回顾2006年指南,详细阐述这些变动并提供管理决策的依据。

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