Hein K, Schreiber K, Cohen M I, Koss L G
J Pediatr. 1977 Jul;91(1):123-6. doi: 10.1016/s0022-3476(77)80462-9.
Pelvic examinations, including a Papanicolaou smear of the uterine cervix, were performed on 403 asymptomatic, sexually active adolescent girls aged from 12 to 16 years who were in a youth detention center in New York City. The smears were negative for precancerous abnormalities in 389 girls, but 168 of these had evidence of inflammation or nonspecific atypia. In the remaining 14 smears there was cytologic evidence of early precancerous changes (low-grade cervical intraepithelial neoplasia). The prevalence rate for early neoplastic changes was 35/1,000, far higher than previously reported. Further evaluation of three of these girls, by colposcopy and biopsy, revealed precancerous epithelial abnormalities of varying degrees of severity in two of them. Since all patients screened were sexually active and were asyptomatic, no clinical feature distinguished the 389 with negative cytology from the 14 with intraepithelial neoplasia. Five of the patients with precancerous cellular abnormalities had histories of sexual activity of less than two years. The data suggest that cervical cytologic screening should be incorporated into the routine examination of sexually active female adolescents.
对纽约市一所青少年拘留中心的403名年龄在12至16岁、无症状且有性活动的青春期女孩进行了盆腔检查，包括子宫颈巴氏涂片检查。在389名女孩中，涂片未发现癌前异常，但其中168名有炎症或非特异性异型性的证据。在其余14份涂片中，有早期癌前改变（低度宫颈上皮内瘤变）的细胞学证据。早期肿瘤改变的患病率为35/1000，远高于先前报道。通过阴道镜检查和活检对其中3名女孩进行进一步评估，发现其中2名有不同程度的癌前上皮异常。由于所有接受筛查的患者均有性活动且无症状，因此在细胞学检查阴性的389名患者和有上皮内瘤变的14名患者之间没有临床特征可以区分。5名有癌前细胞异常的患者有不到两年的性活动史。数据表明，宫颈细胞学筛查应纳入有性活动的青春期女性的常规检查。
