Nadim Batool, Beckmann Michael
Mater Health Services, Brisbane, Queensland, Australia.
J Low Genit Tract Dis. 2013 Oct;17(4):385-9. doi: 10.1097/LGT.0b013e31827ccea9.
This study aimed to determine if there are differences in the histological findings of excisional biopsies between younger women (aged ≤25 years) and older women who undergo large loop excision of the transformation zone or cone biopsy for a biopsy-proven high-grade squamous intraepithelial lesion (HSIL).
A retrospective cohort analysis of women referred to a tertiary hospital colposcopy clinic with a colposcopically directed biopsy of HSIL (cervical intraepithelial neoplasia 2 [CIN 2] or CIN 3) during the period of 2008 to 2011 was performed.The histological excisional biopsy specimens for younger women (aged ≤25 years) were compared with those of older women (aged >25 years.) Bivariate analysis comparing demographic characteristics and outcomes across the 2 study groups was initially undertaken to identify potential confounders for inclusion in the multivariate analysis.
Of 348 women who had a satisfactory colposcopic assessment and reported no previous treatment for cervical intraepithelial neoplasia, 87 were 25 years or younger, and 261 women were older than 25 years. After excisional biopsy of the cervix, the histological specimen for younger women was more likely to be reported as CIN 1 or no dysplasia (16.3% vs 8.2%). When adjusted for confounders (parity, smoking, previous sexual infection, and referring Pap smear), age less than 25 years remained an independent predictor of having a histological excisional biopsy specimen reported as CIN 1 or no dysplasia (adjusted odds ratio = 2.35; 95% confidence interval = 1.0-5.49).
Younger women with biopsy-proven HSIL (CIN 2/3), have a higher likelihood that the histological specimen after an excisional biopsy of the cervix will be reported as CIN 1 or no dysplasia.
本研究旨在确定在因活检证实为高级别鳞状上皮内病变（HSIL）而接受转化区大环形切除术或锥形活检的年轻女性（年龄≤25岁）和老年女性之间，切除活检的组织学结果是否存在差异。
对2008年至2011年期间转诊至一家三级医院阴道镜诊所并接受阴道镜引导下HSIL（宫颈上皮内瘤变2级[CIN 2]或CIN 3）活检的女性进行回顾性队列分析。将年轻女性（年龄≤25岁）的组织学切除活检标本与老年女性（年龄>25岁）的标本进行比较。最初对两个研究组的人口统计学特征和结果进行双变量分析，以确定纳入多变量分析的潜在混杂因素。
在348名阴道镜评估满意且报告既往未接受宫颈上皮内瘤变治疗的女性中，87名年龄在25岁及以下，261名女性年龄超过25岁。宫颈切除活检后，年轻女性的组织学标本更有可能被报告为CIN 1或无发育异常（16.3%对8.2%）。在对混杂因素（产次、吸烟、既往性感染和转诊巴氏涂片）进行调整后，年龄小于25岁仍然是组织学切除活检标本被报告为CIN 1或无发育异常的独立预测因素（调整后的优势比=2.35；95%置信区间=1.0-5.49）。
活检证实为HSIL（CIN 2/3）的年轻女性，宫颈切除活检后的组织学标本更有可能被报告为CIN 1或无发育异常。
