Boras V F, Duggan M A
Department of Pathology, Foothills Hospital, Calgary, Alberta, Canada.
Acta Cytol. 1989 Mar-Apr;33(2):223-7.
Human papillomavirus (HPV) infections cause the koilocytotic and dyskeratotic cell changes seen in cervical smears. Although the koilocyte is pathognomonic, the role of the isolated dyskeratocyte in predicting the presence of HPV infection is not yet defined. One hundred patients, ranging in age from 7 to 71 years (mean: 26 years), with a cytologic diagnosis of dyskeratotic cells and a simultaneous, colposcopically directed cervical biopsy, were studied to determine the tissue correlates of such cells. On biopsy, 61 had condylomatous changes; 14 of the 61 had an associated cervical intraepithelial neoplasia (CIN). Of the 39% without condylomatous changes, 12 had an unremarkable biopsy, 19 had squamous metaplasia, 5 had hyperkeratosis and 3 had CIN. Condyloma plus CIN was diagnosed at least two months previously in 14 of these 39 patients; 6 had CIN alone. The results show that dyskeratocytes in cervical smears are predictive of a simultaneous HPV infection in 61% of the cases and of an infection at some time in 75% of the cases. Since only 14% of the patients had a condyloma plus CIN and 3% had CIN alone, patients with a smear diagnosis of dyskeratotic cells may need a more careful follow-up. Other histologic correlates of the dyskeratocyte included squamous metaplasia and hyperkeratosis.
人乳头瘤病毒（HPV）感染会导致宫颈涂片出现挖空细胞和角化不良细胞改变。尽管挖空细胞具有诊断特异性，但孤立的角化不良细胞在预测HPV感染存在方面的作用尚未明确。对100例年龄在7至71岁（平均26岁）之间、细胞学诊断为角化不良细胞且同时进行了阴道镜引导下宫颈活检的患者进行研究，以确定此类细胞的组织相关性。活检显示，61例有湿疣样改变；61例中有14例伴有宫颈上皮内瘤变（CIN）。在无湿疣样改变的39%患者中，12例活检无异常，19例有鳞状化生，5例有角化过度，3例有CIN。在这39例患者中，14例在至少两个月前被诊断为湿疣加CIN；6例仅有CIN。结果表明，宫颈涂片中的角化不良细胞在61%的病例中可预测同时存在HPV感染，在75%的病例中可预测曾有过感染。由于仅有14%的患者有湿疣加CIN，3%的患者仅有CIN，因此涂片诊断为角化不良细胞的患者可能需要更密切的随访。角化不良细胞的其他组织学相关性包括鳞状化生和角化过度。
