Reich Olaf, Regauer Sigrid, McCluggage W G, Bergeron Christine, Redman Charles
Department of Obstetrics and Gynecology (O.R.) Institute of Pathology (S.R.), Medical University of Graz, Graz, Austria Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK (W.G.M.) Department of Pathology, Laboratoire Cerba, Cergy Pontoise, France (C.B.) Department of Gynaecological Oncology, University Hospitals of North Midlands, Stoke-on-Trent, UK (C.R.).
Int J Gynecol Pathol. 2017 Nov;36(6):517-522. doi: 10.1097/PGP.0000000000000381.
Quality assurance and research in colposcopy and cervical pathology require standardized terminologies and reporting. However, clinical and histologic definitions of the cervical transformation zone (TZ) and squamocolumnar junction (SCJ) vary considerably. We aimed to identify areas of agreement and areas where work is required to standardize the definitions of the TZ and the SCJ. We conducted a survey among the board members of the European Federation of Colposcopy member societies and members of the International Society of Gynecological Pathologists. Overall, 22 expert colposcopists and 34 gynecologic pathologists responded. There was broad agreement that the TZ is the area where squamous metaplasia has occurred. There was consensus that the original SCJ can appear colposcopically indistinct in cases of maturation of the metaplastic squamous epithelium but can be identified histologically by the presence of the so-called last cervical gland. It was agreed that the border between the metaplastic squamous epithelium and the columnar epithelium on the surface of the cervix is called the new SCJ. Areas where work is required include the questions as to whether the cervical crypts lined by columnar epithelium in the field of squamous metaplasia are an integral part of the TZ or not and whether the individual microscopic borders between the metaplastic squamous epithelium of glandular crypts and the residual columnar epithelium of glandular crypts should be considered as part of the new SCJ or not. This paper is a step in an attempt to standardize colposcopic and histologic definitions among colposcopists and pathologists.
阴道镜检查和宫颈病理学的质量保证及研究需要标准化的术语和报告。然而，宫颈转化区（TZ）和鳞柱交界（SCJ）的临床及组织学定义差异很大。我们旨在确定达成共识的领域以及在TZ和SCJ定义标准化方面仍需开展工作的领域。我们对欧洲阴道镜联合会成员协会的董事会成员以及国际妇科病理学家协会的成员进行了一项调查。总体而言，22名专家阴道镜医师和34名妇科病理学家做出了回应。对于TZ是发生鳞状上皮化生的区域这一点，存在广泛共识。对于在化生的鳞状上皮成熟的情况下，原始SCJ在阴道镜下可能不清晰，但可通过所谓的最后一个宫颈腺的存在在组织学上予以识别这一点，也达成了共识。大家一致认为，宫颈表面化生的鳞状上皮与柱状上皮之间的边界称为新的SCJ。仍需开展工作的领域包括：鳞状上皮化生区域内由柱状上皮衬里的宫颈隐窝是否是TZ的一个组成部分，以及腺性隐窝化生的鳞状上皮与腺性隐窝残余柱状上皮之间的个体微观边界是否应被视为新SCJ的一部分等问题。本文是朝着在阴道镜医师和病理学家之间实现阴道镜检查和组织学定义标准化迈出的一步。
