Himmelstein L R
Department of Obstetrics and Gynecology, George Washington University Medical Center, Washington, D.C.
J Reprod Med. 1989 Sep;34(9):634-7.
The accepted procedure for evaluating women with inflammatory atypia on a Papanicolaou smear has changed over the years. Early studies reflected a general consensus that inflammatory atypia was normal and required no further evaluation. In the early 1970s several authors noted a higher-than-expected incidence of cervical intraepithelial neoplasia (CIN) and even cervical cancer in these patients. Further work in the late 70s and early 80s demonstrated that up to 79% of patients who had both initial and repeat atypical Papanicolaou smears had CIN or worse on biopsy. Those studies were flawed in their methodology. However, recent studies have been more sound methodologically. They clearly showed that 18.79%-56.00% of initially atypical smears are associated with CIN, human papillomavirus or cervical cancer. Furthermore, they demonstrated an alarmingly high number of false-negative repeat smears. Those studies pointed to a need for a more aggressive approach to the evaluation of inflammatory atypia seen on the initial smear.
多年来，巴氏涂片检查中对有炎性非典型细胞的女性进行评估的公认程序已经发生了变化。早期研究反映出一种普遍共识，即炎性非典型细胞是正常的，无需进一步评估。在20世纪70年代早期，几位作者指出这些患者中宫颈上皮内瘤变（CIN）甚至宫颈癌的发病率高于预期。70年代末和80年代初的进一步研究表明，初次和重复巴氏涂片均为非典型的患者中，高达79%的人活检显示有CIN或更严重病变。那些研究在方法上存在缺陷。然而，最近的研究在方法上更加合理。它们清楚地表明，最初非典型涂片中有18.79% - 56.00%与CIN、人乳头瘤病毒或宫颈癌有关。此外，它们还显示重复涂片的假阴性数量高得惊人。那些研究表明，对于初次涂片所见的炎性非典型细胞，需要采取更积极的评估方法。
