Carmichael J A, Jeffrey J F, Steele H D, Ohlke I D
Am J Obstet Gynecol. 1984 Mar 1;148(5):685-90. doi: 10.1016/0002-9378(84)90774-9.
A review was made of the cytologic history of 245 patients who developed invasive carcinoma of the cervix, and three groups of patients were identified. Group 1 included 149 patients (60.8%) who had never had a cervical cytologic examination, group 2 included 26 patients (10.6%) whose cytologic history in terms of frequency of examination and or timing was considered to be unsatisfactory, and group 3 included 70 patients (28.6%) whose cytologic history was considered to be satisfactory. Only 53 (35.6%) of the patients in group 1 had Stage I disease. Stage I disease was present in 16 patients (61.5%) of group 2 and in 55 patients (78.6%) of group 3. There was no significant difference between the three groups with respect to site of residence or access to the health care system. Of the patients in group 3, 20 (28.6%) had normal cytologic findings and 50 (71.4%) had abnormal cytologic findings. Of the 50 patients with abnormal cytologic findings, 31 (62.0%) did not have further examination for 6 months or longer after identification of the abnormal smear. The majority of these patients had minor degrees of cytologic abnormalities. A review of 299 original cervical smears revealed that 52 (17.4%) had been significantly undercalled, but only 21 (7.0%) had been undercalled as normal. In this study, 28 patients (11.4%) developed adenocarcinoma. In these patients, staging was unrelated to screening.
对245例发生宫颈浸润癌的患者的细胞学检查史进行了回顾，并确定了三组患者。第1组包括149例（60.8%）从未进行过宫颈细胞学检查的患者，第2组包括26例（10.6%）其细胞学检查频率和/或时间方面的病史被认为不满意的患者，第3组包括70例（28.6%）其细胞学检查史被认为满意的患者。第1组中只有53例（35.6%）患者为I期疾病。第2组中有16例（61.5%）患者为I期疾病，第3组中有55例（78.6%）患者为I期疾病。三组患者在居住地点或获得医疗保健系统方面没有显著差异。在第3组患者中，20例（28.6%）细胞学检查结果正常，50例（71.4%）细胞学检查结果异常。在这50例细胞学检查结果异常的患者中，31例（62.0%）在发现异常涂片后6个月或更长时间没有进行进一步检查。这些患者大多数有轻度细胞学异常。对299份原始宫颈涂片的回顾显示，52份（17.4%）被显著低估，但只有21份（7.0%）被低估为正常。在本研究中，28例（11.4%）发生腺癌。在这些患者中，分期与筛查无关。
