Doornewaard H, Woudt J M, Sie-Go D M, Kooijman C D
Laboratorium Cyt-U-Universitair, Utrecht.
Ned Tijdschr Geneeskd. 1991 Sep 7;135(36):1642-5.
To evaluate the changed policy regarding cervical smears with mild atypia in the Netherlands (before 1988 classified as Pap II, thereafter as Pap IIIA), an descriptive study was carried out in the laboratory of gynaecological cytology Cyt-U-Universitair (University of Utrecht). All women who in 1988 had a first smear with mild atypia were included. After a follow-up period of 2 years the final diagnosis was noted. The results of the follow-up of cervical smears with mild atypia were compared with the follow-up results of moderate atypia. A selection was made of 477 women. In 55% of the cases no dysplasia was found during the 2 years of follow-up. In 12% of the cases severe dysplasia, carcinoma in situ or carcinoma was found. Compared with the smears with moderate atypia the dysplasia in the follow-up of mild atypia led to fewer cases of proven dysplasia. In addition the dysplasia in these cases was of a lower grade. The group of women referred to the gynaecologist after the smear with mild atypia was remarkably large (30%). As the results show, the policy of careful follow-up of women with mild atypia in the cervical smear has been a good one. It implies classifying mild atypia as Pap IIIA. As many women (55%) do not display cervical dysplasia within a 2 year follow-up period, the policy of making a repeat smear before referring appears justified.
为评估荷兰关于轻度非典型性宫颈涂片的政策变化（1988年前归类为巴氏Ⅱ级，此后归类为巴氏ⅢA级），在乌得勒支大学妇科细胞学实验室Cyt-U-Universitair开展了一项描述性研究。纳入了所有在1988年首次涂片显示轻度非典型性的女性。经过2年的随访期后记录最终诊断结果。将轻度非典型性宫颈涂片的随访结果与中度非典型性的随访结果进行比较。选取了477名女性。在55%的病例中，随访2年期间未发现发育异常。在12%的病例中发现了重度发育异常、原位癌或癌。与中度非典型性涂片相比，轻度非典型性涂片随访中的发育异常导致确诊发育异常的病例较少。此外，这些病例中的发育异常级别较低。在轻度非典型性涂片后转诊至妇科医生的女性群体比例相当大（30%）。结果表明，对宫颈涂片显示轻度非典型性的女性进行密切随访的政策是一项好政策。这意味着将轻度非典型性归类为巴氏ⅢA级。由于许多女性（55%）在2年随访期内未出现宫颈发育异常，在转诊前进行重复涂片的政策似乎是合理的。
