Gynecology Department of Peking University Third Hospital, Beijing 100191, PR China.
Eur J Obstet Gynecol Reprod Biol. 2010 Apr;149(2):215-7. doi: 10.1016/j.ejogrb.2009.12.034. Epub 2010 Jan 20.
To explore the risk of CIN II or greater in patients with cytologically interpreted atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion (ASC-H) in a one-year follow-up period.
Patients with ASC-H accepted high-risk human papillomavirus (HPV) testing (Hybrid Capture II), colposcopy-directed biopsy, and endocervical curettage at baseline. Patients with CIN 1 or less were re-examined with cytology at 4-6-month intervals for up to 12 months only if the cytologic result was ASC-US or worse. Correlation between HPV infection at baseline and the follow-up results was analyzed using Chi-square statistical method and Fisher's exact test.
34.0% (50/147) patients were diagnosed CIN II or greater at baseline. Four patients were diagnosed CIN II or greater at repeat colposcopy among the 65.0% (63/97) of patients who were diagnosed CIN I or less at baseline and had completed follow-up. The HPV positive rate was 61.9% (91/144) at baseline. The correlation coefficient of HPV negativity with CIN I or less was 100% (32/32).
The risk of CIN II or greater among patients with ASC-H was 40% and all patients (100%) with baseline negative HPV showed CIN I or less by cytology during the one-year follow-up period.
探讨细胞学诊断为非典型鳞状细胞，不能排除高级别鳞状上皮内病变（ASC-H）的患者在一年随访期内发生 CIN II 级或更高级别病变的风险。
ASC-H 患者在基线时接受高危型人乳头瘤病毒（HPV）检测（杂交捕获二代）、阴道镜引导下活检和宫颈管搔刮术。如果细胞学结果为 ASC-US 或更差，则仅对 CIN 1 级及以下的患者在 4-6 个月的间隔内进行细胞学复查，最多复查 12 个月。使用卡方检验和 Fisher 确切概率法分析基线 HPV 感染与随访结果的相关性。
基线时诊断为 CIN II 级或更高级别病变的患者占 34.0%（50/147）。在基线时诊断为 CIN I 级及以下且完成随访的 65.0%（63/97）患者中，有 4 例在重复阴道镜检查时被诊断为 CIN II 级或更高级别病变。基线时 HPV 阳性率为 61.9%（91/144）。HPV 阴性与 CIN I 级及以下的相关系数为 100%（32/32）。
ASC-H 患者发生 CIN II 级或更高级别病变的风险为 40%，且所有基线 HPV 阴性的患者（100%）在一年的随访期间通过细胞学检查均表现为 CIN I 级及以下。
