López-Alegría Fanny, De Lorenzi Dino Soares, Quezada Orlando Poblete
Department of Nursing, School of Nursing, Universidad Andres Bello, Santiago, Chile.
Universidade de Caxias do Sul, Department of Obstetrics and Gynecology, Rio Grande do Sul, Brazil, MD. Professor, Department of Obstetrics and Gynecology, Universidade de Caxias do Sul, Rio Grande do Sul, Brazil.
Sao Paulo Med J. 2014;132(1):15-22. doi: 10.1590/1516-3180.2014.1321597.
The concept that the presence of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H) was introduced in the 2001 Bethesda System of cervical cytology classification. This nomenclature defines cervical cancer precursor lesions. The objective of this study was to investigate the colpocytological-histological results from a three-year follow-up conducted on a cohort of women with reports of ASC-H who were attended during 2005-2006 at clinics of the Southern Metropolitan Healthcare Service of Santiago, Chile.
Prospective cohort study at primary healthcare clinics in Santiago, Chile.
Colpocytological-histological follow-up was conducted over a three-year period on 92 women with cytological reports of ASC-H who were attended at primary healthcare clinics during 2005-2006.
At the end of the follow-up period, high-grade lesions were evaluated and the following outcomes were observed: seven women presented invasive cancer (7.6%), 49 presented high-grade lesions (53.3%), 26 presented low-grade lesions (28.2%) and 10 presented normal results (10.9%). The "Conditional Probabilities Tree Diagram" was used to show the results from tests and the times of lesion detection. It demonstrated that, after a first report of ASC-H, clinical management needed to be interventionist.
The follow-up on our cohort of women showed that the majority of uncertain ASC-H diagnoses (82.6%) had abnormal colposcopic results and that during the follow-up using ASC-H smears, two out of every three women developed high-grade lesions.
2001年的宫颈细胞学分类贝塞斯达系统引入了非典型鳞状细胞的存在不能排除高级别鳞状上皮内病变（ASC-H）这一概念。该命名法定义了宫颈癌前病变。本研究的目的是调查对2005年至2006年期间在智利圣地亚哥南部大都会医疗服务诊所就诊的一组报告有ASC-H的女性进行三年随访的阴道镜细胞学-组织学结果。
在智利圣地亚哥的初级保健诊所进行的前瞻性队列研究。
对92名在2005年至2006年期间在初级保健诊所就诊且细胞学报告为ASC-H的女性进行了为期三年的阴道镜细胞学-组织学随访。
在随访期结束时，对高级别病变进行了评估，观察到以下结果：7名女性出现浸润癌（7.6%），49名出现高级别病变（53.3%），26名出现低级别病变（28.2%），10名结果正常（10.9%）。使用“条件概率树状图”展示检测结果和病变检测时间。结果表明，在首次报告ASC-H后，临床管理需要采取干预措施。
对我们这组女性的随访表明，大多数不确定的ASC-H诊断（82.6%）阴道镜检查结果异常，并且在使用ASC-H涂片进行随访期间，每三名女性中有两名发展为高级别病变。
