Wheelock J B, Kaminski P F
Department of Obstetrics and Gynecology, United States Air Force Medical Center Keesler, Keesler Air Force Base, Mississippi 39534.
J Reprod Med. 1989 Oct;34(10):815-7.
The significance of repeat cervical cytology was evaluated in patients referred for colposcopy because of previous cervical intraepithelial neoplasia (CIN) 1 on cytologic smears. Between Jan 1, 1984, and Dec 31, 1986, 273 such patients were seen. The results of the repeat smears obtained prior to colposcopy were compared with those of colposcopically directed biopsies and of follow-up. The repeat smear was negative in 99 patients; it disclosed squamous atypia in 84, CIN 1 in 64 and CIN 2 or 3 in 26. Thirty-two patients whose repeat smear was negative had biopsy-documented CIN 1-3. Of the 84 patients with squamous atypia, 37 (44%) had biopsy-documented CIN 1-3. Thus, second smears in this group failed to disclose precancerous lesions in at least 69 patients. Of the 90 patients whose repeat smear were interpreted as showing CIN, 64, or 71%, had biopsy-documented CIN 1-3. Patients with a repeat smear showing CIN 1 or greater and normal colposcopy or a negative cervical biopsy must be followed closely: 33% of our study group (6 of 18) were found to have CIN later.
对因之前细胞学涂片显示宫颈上皮内瘤变1级（CIN 1）而转诊接受阴道镜检查的患者，评估重复宫颈细胞学检查的意义。在1984年1月1日至1986年12月31日期间，共诊治了273例此类患者。将阴道镜检查前获得的重复涂片结果与阴道镜引导下活检结果及随访结果进行比较。99例患者的重复涂片结果为阴性；84例显示鳞状上皮异型性，64例为CIN 1，26例为CIN 2或3。32例重复涂片结果为阴性的患者经活检证实有CIN 1 - 3。在84例有鳞状上皮异型性的患者中，37例（44%）经活检证实有CIN 1 - 3。因此，该组患者的第二次涂片至少未能发现69例癌前病变。在90例重复涂片被解读为显示CIN的患者中，64例（71%）经活检证实有CIN 1 - 3。重复涂片显示CIN 1或更高级别且阴道镜检查正常或宫颈活检阴性的患者必须密切随访：我们研究组中有33%（18例中的6例）后来被发现患有CIN。
