Kristensen G B, Skyggebjerg K D, Hølund B, Holm K, Hansen M K
Department of Gynecology and Obstetrics, University Hospital, Odense, Denmark.
Acta Cytol. 1991 Jan-Feb;35(1):47-50.
The cytologic histories of 376 women presenting with invasive carcinoma of the cervix were analyzed. In total, 202 (53.7%) of these women had had 355 smears taken during the three years preceding presentation. All 320 smears with an original cytologic diagnosis of less than cancer were reviewed. The original cytologic diagnosis was low in 95 (30.6%) of 310 adequate smears. Originally, 96 (30.9%) of the adequate smears were evaluated as negative; at review, only 55 (17.5%) of the adequate smears were evaluated as negative. Comparing the review diagnoses to the 355 total smears, the rates of negative smears were 13.5% (42 of 310) for squamous-cell carcinoma, 30.0% (12 of 40) for adenocarcinoma and 20.0% (1 of 5) for adenosquamous carcinoma (P less than .05). The cellular composition of the smear was significantly related to the cytologic detection of abnormalities: endocervical cylindrical and/or metaplastic cells were seen in only 45.5% of smears diagnosed as negative, but in 84.4% and 97.8% of smears diagnosed as atypia and cervical intraepithelial neoplasia, respectively P less than .00001). Smears without endocervical cells should be considered inadequate and should be repeated.
对376例宫颈浸润癌女性的细胞学检查病史进行了分析。这些女性中，共有202例（53.7%）在就诊前三年进行了355次涂片检查。对所有最初细胞学诊断为非癌的320份涂片进行了复查。在310份合格涂片中，95份（30.6%）最初的细胞学诊断为低度病变。最初，96份（30.9%）合格涂片被评估为阴性；复查时，只有55份（17.5%）合格涂片被评估为阴性。将复查诊断与355份总涂片进行比较，鳞状细胞癌的涂片阴性率为13.5%（310份中的42份），腺癌为30.0%（40份中的12份），腺鳞癌为20.0%（5份中的1份）（P<0.05）。涂片的细胞组成与异常的细胞学检测显著相关：仅45.5%诊断为阴性的涂片中可见宫颈管柱状和/或化生细胞，但在诊断为非典型和宫颈上皮内瘤变的涂片中分别为84.4%和97.8%（P<0.00001）。没有宫颈管细胞的涂片应被视为不合格，应重新进行检查。
