Ratree Sasivimon, Kleebkaow Pilaiwan, Aue-Aungkul Apiwat, Temtanakitpaisan Amornrat, Chumworathayi Bandit, Luanratanakorn Sanguanchoke
Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. Email:
Asian Pac J Cancer Prev. 2019 Mar 26;20(3):683-686. doi: 10.31557/APJCP.2019.20.3.683.
Objectives: To evaluate prevalence of underlying significant pathologies among women with cervical smears rated as ‘atypical squamous cells cannot exclude high grade squamous intraepithelial lesion (ASC-H)’, as well as associated risk factors. Methods: Medical records were reviewed of all consecutive women with ASC-H smears who had undergone colposcopy at Srinagarind Hospital from January 2008 to July 2016. Significant pathology results included cervical intraepithelial neoplasia (CIN) 2-3, adenocarcinoma in situ (AIS), endometrial hyperplasia, and cancer of any original site. Result: During the study period, 133 women with ASC-H were reviewed. The mean age was 45.3 years (range 21-72). The histopathologic results for the 133 women were as follows: no lesions (58; 43.6%), CIN 1 (34; 25.6%), CIN 2-3 (33; 24.8%), AIS (2; 1.5%), and cervical cancer (6; 4.5%). The overall rate of significant pathology was 30.8% (95% confidence interval, 22.9%-38.8%). Women younger than 40 years old carried a higher risk of harboring significant lesions when compared to older women (41.7% versus 27.8%, respectively). There was no significant impact of parity and menopausal status on the risk of significant pathology results. Conclusion: The rate of significant histopathologies among women with ASC-H smears in this study was approximately 31% and the associated risk factor was patient age.
评估宫颈涂片结果为“非典型鳞状细胞不能排除高级别鳞状上皮内病变（ASC-H）”的女性潜在重大病理情况的患病率及其相关危险因素。方法：回顾性分析2008年1月至2016年7月在诗里拉吉医院接受阴道镜检查的所有连续ASC-H涂片女性的病历。重大病理结果包括宫颈上皮内瘤变（CIN）2-３级、原位腺癌（AIS）、子宫内膜增生以及任何原发部位的癌症。结果：在研究期间，对133例ASC-H女性进行了评估。平均年龄为45.3岁（范围21-72岁）。133例女性的组织病理学结果如下：无病变（58例；43.6%）、CIN 1级（34例；25.6%）、CIN 2-3级（33例；24.8%）、AIS（2例；1.5%）和宫颈癌（6例；4.5%）。重大病理的总体发生率为30.8%（95%置信区间，22.9%-38.8%）。与老年女性相比，40岁以下的女性患重大病变的风险更高（分别为41.7%和27.8%）。产次和绝经状态对重大病理结果的风险没有显著影响。结论：本研究中ASC-H涂片女性的重大组织病理学发生率约为31%，相关危险因素为患者年龄。
