Wetrich D W
Am J Obstet Gynecol. 1986 Jun;154(6):1339-49. doi: 10.1016/0002-9378(86)90722-2.
Two thousand one hundred ninety-four patients with abnormal Papanicolaou smears were evaluated by colposcopy without endocervical curettage in the initial part of the series but with routine endocervical curettage in the latter part. Forty-two cases of microinvasion-invasion were all accurately diagnosed with no postcryotherapy occurrence of these lesions. Evaluation of the Papanicolaou smear, colposcopic biopsy specimens, squamocolumnar junction location, and use of surgical removal for severe dysplasia-carcinoma in situ appeared to be most important in the successful outcome. Endocervical curettage played a minor role. Multiple positive cross correlations between Papanicolaou smear severity, colposcopic biopsy specimen severity, squamocolumnar junction nonvisualization, positive results of endocervical curettage, increased lesion size, increased age, and microinvasion-invasion occurrence were all demonstrated.
在该系列研究初期，2194例巴氏涂片异常的患者接受了阴道镜检查，但未进行宫颈管搔刮术；而在后期则进行常规宫颈管搔刮术。42例微浸润-浸润病例均被准确诊断，且这些病变在冷冻治疗后未再出现。巴氏涂片评估、阴道镜活检标本、鳞柱交界位置以及对重度发育异常-原位癌采用手术切除似乎对成功治疗最为重要。宫颈管搔刮术起的作用较小。研究证实，巴氏涂片严重程度、阴道镜活检标本严重程度、鳞柱交界不可见、宫颈管搔刮术阳性结果、病变大小增加、年龄增长以及微浸润-浸润发生之间均存在多重正相关。
