Brotzman G L, Julian T M
Medical College of Wisconsin, Milwaukee, USA.
Am Fam Physician. 1996 Mar;53(4):1154-62.
The Bethesda system has helped to standardize the nomenclature for cervical cytology. Previously used cytologic classification systems failed to define modern histopathologic concepts. The Bethesda system also has dramatically increased the number of Papanicolaou smears classified as minimally abnormal. While high-grade squamous intraepithelial lesions (cervical intraepithelial neoplasia 2 and 3) clearly require colposcopic evaluation, the minimally abnormal Pap smear may not always require colposcopic assessment. Common minimally abnormal cytologic categories include atypical squamous cells of undetermined significance, low-grade intraepithelial lesions and atypical glandular cells. New guidelines propose a conservative and expectant approach for these mild abnormalities. Understanding the meaning of these Pap smear reports and instituting appropriate treatments will improve patients care, reduce clinician anxiety and help ensure the best care for patients.
贝塞斯达系统有助于规范宫颈细胞学的命名法。以前使用的细胞学分类系统未能界定现代组织病理学概念。贝塞斯达系统还显著增加了被归类为轻度异常的巴氏涂片数量。虽然高级别鳞状上皮内病变（宫颈上皮内瘤变2级和3级）显然需要进行阴道镜评估，但轻度异常的巴氏涂片不一定总是需要进行阴道镜评估。常见的轻度异常细胞学类别包括意义不明确的非典型鳞状细胞、低级别上皮内病变和非典型腺细胞。新指南针对这些轻度异常提出了一种保守和观察等待的方法。理解这些巴氏涂片报告的含义并采取适当的治疗措施将改善患者护理、减轻临床医生的焦虑，并有助于确保为患者提供最佳护理。
