Cheltenham General Hospital, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2009 Nov;147(1):83-5. doi: 10.1016/j.ejogrb.2009.07.007. Epub 2009 Sep 8.
To review the outcome of women presenting with borderline glandular smear on cervical cytology and to investigate correlation between cytology, colposcopy and histology and subsequent smear history.
A 5 year retrospective analysis of outcome in all women reported with borderline glandular changes on cytology between 2001 and 2005 at the John Radcliffe Hospital, Oxford, and Cheltenham General Hospital, Gloucestershire, was performed. Cytology, colposcopy, histology and follow-up cytology data at 6, 12 and 24 months after index smear were collated.
Of 92 women with borderline glandular smears, 56 were referred for colposcopy. This accounts for 0.9% of the total referral (6293) to the colposcopy units. A significant rate of abnormal histology was noted, with CIN 1, 2, 3, CGIN or worse in 20 women (36%) and benign pathology in 18 women (32%). Colposcopy had a sensitivity of 82%, specificity of 39%, negative predictive value of 80% and positive predictive value of 49% in predicting abnormal (premalignant/malignant) histology. Only one woman with normal histology at presentation had subsequent abnormal cytology (1/31), whereas abnormal histology at presentation was strongly associated with subsequent abnormality on follow-up cytology over 24 months (8/21) with a p value=0.0058.
Colposcopic examination and biopsy of colposcopically identified abnormalities is reliable, with negative colposcopy having a high negative predictive value. We also recommend thorough colposcopic examination before any invasive investigation as over treatment may impact on the future reproductive outcome [1].
回顾宫颈细胞学检查中出现边界性腺体涂片的女性的结局，并研究细胞学、阴道镜和组织学之间的相关性及其随后的涂片病史。
对 2001 年至 2005 年在牛津约翰拉德克利夫医院和格洛斯特郡切尔滕纳姆综合医院报告的所有细胞学检查出现边界性腺体改变的女性的结果进行了 5 年回顾性分析。整理了索引涂片后 6、12 和 24 个月的细胞学、阴道镜、组织学和随访细胞学数据。
在 92 例边界性腺体涂片的女性中，有 56 例被转诊行阴道镜检查。这占阴道镜检查单位（6293 例）总转诊量的 0.9%。组织学检查发现异常率较高，20 例（36%）有 CIN1、2、3、CGIN 或更严重病变，18 例（32%）为良性病变。阴道镜检查在预测异常（癌前/恶性）组织学方面具有 82%的敏感性、39%的特异性、80%的阴性预测值和 49%的阳性预测值。在最初表现正常的女性中，仅有 1 例随后出现异常细胞学（1/31），而在最初表现异常的女性中，在 24 个月的随访细胞学中，随后出现异常的可能性较大（8/21），p 值=0.0058。
阴道镜检查和阴道镜下发现的异常组织活检是可靠的，阴性阴道镜检查具有较高的阴性预测值。我们还建议在进行任何侵袭性检查之前进行彻底的阴道镜检查，因为过度治疗可能会影响未来的生殖结果[1]。
