Cakmak Bülent, Köseoğlu Doğan Reşid
Departments of Obstetrics and Gynecology, Gaziosmanpaşa University, Faculty of Medicine, TOKAT, TURKEY.
Turk Patoloji Derg. 2014;30(1):38-42. doi: 10.5146/tjpath.2013.01212.
There is insufficient data on geriatric period cervical cytology screening in our country. The aim of this study was to compare the cervical cytological results among elderly women and women aged between 45-64 years.
A comparison of cervical cytological results of 273 women aged over 65 years and 388 women aged between 45-64 years from January 2010 to June 2013 was performed for presence of cytological abnormalities. Adequacy was assessed according to the criteria of the 2001 Bethesda System. Cervical cytological abnormalities were classified as follows: atypical squamous cell of undetermined significance (ASCUS), cannot exclude a high-grade squamous intraepithelial lesion (ASC-H), low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma (SSC).
Overall, the prevalence of cytological abnormality was 3% and the prevalence of ASCUS, ASCH, LSIL, and HSIL was 1.8%, 0.3%, 0.6% and 0.3%, respectively. Cytological abnormalities were detected to be higher in the geriatric group in comparison to the postmenopausal group (%5.1 vs. %1.5) (p=0.008). ASCUS was detected to be 3.7% in the geriatric group and 0.5% in the postmenopausal group (p=0.005). There was no statistically significant difference between the groups in means of other cytological anomalies. The reactive inflammatory changes were detected more in the postmenopausal group and atrophic changes in the geriatric group (p < 0.001).
It should not be forgotten that although the cervical screening follow-up program is discontinued in elderly women, squamous intraepithelial lesions can still be encountered in this group even if the rate is low.
我国关于老年期宫颈细胞学筛查的数据不足。本研究旨在比较老年女性与45 - 64岁女性的宫颈细胞学检查结果。
对2010年1月至2013年6月期间273名65岁以上女性和388名45 - 64岁女性的宫颈细胞学检查结果进行比较，以确定是否存在细胞学异常。根据2001年贝塞斯达系统的标准评估标本的充足性。宫颈细胞学异常分类如下：意义不明确的非典型鳞状细胞（ASCUS）、不能排除高级别鳞状上皮内病变（ASC-H）、低级别鳞状上皮内病变（LSIL）、高级别鳞状上皮内病变（HSIL）和鳞状细胞癌（SSC）。
总体而言，细胞学异常的患病率为3%，ASCUS、ASCH、LSIL和HSIL的患病率分别为1.8%、0.3%、0.6%和0.3%。与绝经后组相比，老年组的细胞学异常检出率更高（5.1%对1.5%）（p = 0.008）。老年组ASCUS的检出率为3.7%，绝经后组为0.5%（p = 0.005）。两组在其他细胞学异常的均值方面无统计学显著差异。绝经后组的反应性炎症改变检出更多，老年组的萎缩性改变检出更多（p < 0.001）。
不应忘记，尽管老年女性停止了宫颈筛查随访计划，但即使该组的发生率较低，仍可能遇到鳞状上皮内病变。
