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宫颈涂片检查结果异常的女性的随访：一项前瞻性队列研究。

Follow-up of women with inadequate Pap smears: a prospective cohort study.

作者信息

López-Alegría Fanny, Lorenzi Dino Roberto Soares De, Poblete Orlando Quezada

机构信息

School of Nursing, Universidad Andres Bello, Santiago, Chile.

Department of Obstetrics and Gynecology, University of Caxias do Sul, Brazil.

出版信息

Sao Paulo Med J. 2015 Feb;133(1):20-7. doi: 10.1590/1516-3180.2013.7070004. Epub 2015 Jan 1.

DOI:10.1590/1516-3180.2013.7070004
PMID:25626852
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10496621/
Abstract

CONTEXT AND OBJECTIVE

Inadequate Pap smears do not provide satisfactory cell samples for evaluation, thus making it more difficult to detect cervical cytological abnormalities. The objective of this study was to determine the cytological and histological follow-up results from women with inadequate smear reports in primary healthcare centers in Santiago, Chile 2010-2011.

DESIGN AND SETTING

Prospective cohort study at primary healthcare clinics in Santiago, Chile.

METHODS

The population was taken from the "Cito-Expert" database of 2010. The data were then organized according to the cytological and histological follow-up results of 2,547 women with inadequate cervical cytological reports over the 12-month period. The samples were assigned to groups based on the cause of inadequacy (smears with endocervical cells alone; insufficient, hemorrhagic, inflammatory or poorly fixed samples; insufficient and hemorrhagic samples; or insufficient and inflammatory specimens). The data were analyzed using the "conditional probability tree diagram" and descriptive statistics.

RESULT

Half of the women (n = 1,285) met the requirements of the Ministry of Health for repeating these inadequate smears, and 1,104 of these women had normal cytological results (85.9%). The detection rate for cervical lesions according to group ranged from 0% (smears with endocervical cells alone or insufficient and hemorrhagic specimens) to 4.1% (poor fixation).

CONCLUSION

The large proportion of normal results justifies revision of the current clinical guidelines. The results showed that it is not necessary to repeat the Pap test early on, with the exception of inadequate hemorrhagic and inflammatory cytological results.

摘要

背景与目的

不满意的巴氏涂片无法提供用于评估的满意细胞样本，从而增加了检测宫颈细胞学异常的难度。本研究的目的是确定2010 - 2011年智利圣地亚哥初级医疗中心涂片报告不满意的女性的细胞学和组织学随访结果。

设计与地点

智利圣地亚哥初级医疗诊所的前瞻性队列研究。

方法

研究人群取自2010年的“Cito - Expert”数据库。然后根据2547名宫颈细胞学报告不满意的女性在12个月期间的细胞学和组织学随访结果对数据进行整理。样本根据不满意的原因分组（仅含宫颈管细胞的涂片；样本不足、出血、炎症或固定不佳；样本不足且出血；或样本不足且有炎症）。使用“条件概率树形图”和描述性统计分析数据。

结果

一半的女性（n = 1285）符合卫生部重复这些不满意涂片的要求，其中1104名女性细胞学结果正常（85.9%）。根据分组，宫颈病变的检出率从0%（仅含宫颈管细胞的涂片或样本不足且出血的标本）到4.1%（固定不佳）不等。

结论

大部分正常结果证明有必要修订当前的临床指南。结果表明，除了出血性和炎症性细胞学结果不满意的情况外，没有必要早期重复巴氏试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/a1e61f8de9ec/1806-9460-spmj-133-01-20-gf7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/73414dbd2afb/1806-9460-spmj-133-01-20-gf8.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/a1e61f8de9ec/1806-9460-spmj-133-01-20-gf7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/73414dbd2afb/1806-9460-spmj-133-01-20-gf8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/4f6a402ba07d/1806-9460-spmj-133-01-20-gf9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/077693864069/1806-9460-spmj-133-01-20-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/e2fd32e59945/1806-9460-spmj-133-01-20-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/23d35cf132b6/1806-9460-spmj-133-01-20-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c2/10496621/20e918d6dee2/1806-9460-spmj-133-01-20-gf4.jpg
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S Afr Med J. 2012 Nov 22;103(1):34-9. doi: 10.7196/samj.6124.
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[Causes and frequency of unsatisfactory cervicovaginal smears].[宫颈阴道涂片不满意的原因及频率]
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CIN 2/3 and cervical cancer in an organised screening programme after an unsatisfactory or a normal Pap smear: a seven-year prospective study of the Norwegian population-based screening programme.不满意或正常巴氏涂片检查后，在有组织的筛查项目中CIN 2/3和宫颈癌：基于挪威人群筛查项目的七年前瞻性研究
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