Robboy S J, Keh P C, Nickerson R J, Helmanis E K, Prat J, Szyfelbein W M, Taft P D, Barnes A B, Scully R E, Welch W R
Obstet Gynecol. 1978 May;51(5):528-35. doi: 10.1097/00006250-197805000-00003.
Squamous cell abnormalities of the vagina and cervix were evaluated in 1424 women exposed to diethylstilbestrol (DES) in utero. The prevalence of dysplasia was 2.1% and the incidence 0.85/100 person-years of followup. The dysplastic epithelial changes were almost always mild in women with no prior history of dysplasia and was slightly more frequent in the cervix than the vagina. Severe dysplasia and carcinoma in situ (CIS) were encountered only in those subjects specifically referred because of those abnormalities. The most common problem in the diagnosis of these squamous cell changes was the misinterpretation of mature and immature metaplastic cells for dysplastic squamous cells. Discordance between biopsy and cytology was common-place in the detection and followup of dysplasia, especially when it was mild. There were no instances in the study where cytology and biopsy samples from the vagina were both abnormal concurrently. Colposcopically directed biopsies did not increase the frequency of confirmation of cytologic findings. These data suggest that both cytology and biopsy of abnormal segments of the vagina and cervix remain an integral part of the examination of the DES-exposed female during long-term follow-up studies.
对1424名子宫内接触己烯雌酚（DES）的女性的阴道和宫颈鳞状细胞异常情况进行了评估。发育异常的患病率为2.1%，发病率为0.85/100人年随访期。对于既往无发育异常病史的女性，发育异常的上皮改变几乎总是轻度的，且在宫颈比在阴道中略为常见。仅在因这些异常情况而被专门转诊的受试者中发现了重度发育异常和原位癌（CIS）。诊断这些鳞状细胞改变时最常见的问题是将成熟和未成熟化生细胞误判为发育异常的鳞状细胞。在发育异常的检测和随访中，活检与细胞学结果不一致很常见，尤其是在轻度发育异常时。在该研究中，没有出现阴道的细胞学和活检样本同时异常的情况。阴道镜引导下活检并未增加细胞学检查结果得到证实的频率。这些数据表明，在长期随访研究中，对接触DES女性进行检查时，阴道和宫颈异常部位的细胞学检查和活检仍是不可或缺的一部分。
