Marcos Lopes Ana Cristina, Campaner Adriana Bittencourt, Henrique Laílca Quirino
Department of Gynecology and Obstetrics, Santa Casa de Sx00E3;o Paulo School of Medical Sciences, Sx00E3;o Paulo, Brazil.
Acta Cytol. 2016;60(2):139-44. doi: 10.1159/000446206. Epub 2016 May 25.
To evaluate the prevalence of histological high-grade lesions and cervical cancer in patients with ASCUS cytology.
This is a cross-sectional prospective study involving 703 women with a uterus and atypical squamous cells of undetermined significance (ASCUS). The patients were submitted to a colposcopy and underwent a guided biopsy when changes on the colposcopy were detected.
The findings revealed 456 (64.9%) women with a normal colposcopy and 247 (35.1%) with colposcopic abnormalities. The biopsy results were: cervical intraepithelial neoplasia grade 1 (CIN 1) in 51 (20.6%) patients, CIN 2 in 11 (4.5%) patients, CIN 3 in 8 (3.2%) patients, and a negative result in 177 (71.7%) patients; no cases of cancer were detected. Tallying of 456 normal colposcopies and 177 negative biopsies yielded a total of 90.04% negative exams. Furthermore, around 7.2% (51/703) of the patients exhibited CIN 1, a lesion associated with a high potential for regression. The biopsy results were not associated with patient age or menopausal status.
We conclude that cytological surveillance of patients with ASCUS is feasible and safe given the low risk of CIN 2/3 or cervical cancer.
评估非典型鳞状细胞意义不明确（ASCUS）患者中组织学高级别病变和宫颈癌的患病率。
这是一项横断面前瞻性研究，纳入了703名有子宫且存在非典型鳞状细胞意义不明确（ASCUS）的女性。患者接受了阴道镜检查，当在阴道镜检查中发现异常时进行了引导活检。
研究结果显示，456名（64.9%）女性阴道镜检查正常，247名（35.1%）女性存在阴道镜检查异常。活检结果为：51名（20.6%）患者为宫颈上皮内瘤变1级（CIN 1），11名（4.5%）患者为CIN 2，8名（3.2%）患者为CIN 3，177名（71.7%）患者活检结果为阴性；未检测到癌症病例。456例阴道镜检查正常和177例活检阴性的病例总计，阴性检查结果占90.04%。此外，约7.2%（51/703）的患者表现为CIN 1，这是一种具有高消退潜力的病变。活检结果与患者年龄或绝经状态无关。
我们得出结论，鉴于CIN 2/3或宫颈癌的风险较低，对ASCUS患者进行细胞学监测是可行且安全的。
