Dudding N, Sutton J, Lane S
Department of Histopathology, The General Infirmary at Leeds, UK.
Cytopathology. 1996 Feb;7(1):32-7. doi: 10.1046/j.1365-2303.1996.37282372.x.
The management of women with mild dyskaryosis continues to be the subject of debate. The management of cases with such smears could be improved if additional morphological features were found to be indicative of low/high grade cervical intraepithelial neoplasia (CIN). Our own experience in the routine audit of the diagnostic accuracy of cervical smears had suggested that cases of dyskaryosis with koilcytosis were associated with low risk of CINIII. Two hundred and forty-four cervical smears reported as showing evidence of warty virus infection were reviewed and their subsequent histories noted. Of these smears, 173 demonstrated clear evidence of koilocytosis. Irrespective of the initial grade of dyskaryosis, only 28 cases (16.2%) had underlying CIN or had progressed to CIN over a minimum follow-up period of 21 months. Only two cases (1.2%) showed evidence of CINIII. Koilcytosis is associated with a low risk of CIN and an especially low risk of CINIII. The management of women with koilocytic smears should be modified accordingly.
轻度核异质女性的管理仍然是一个有争议的话题。如果发现其他形态学特征可指示低/高级别宫颈上皮内瘤变（CIN），那么此类涂片病例的管理可能会得到改善。我们自己在宫颈涂片诊断准确性常规审计中的经验表明，伴有挖空细胞的核异质病例与CINIII的低风险相关。对报告显示有疣状病毒感染证据的244份宫颈涂片进行了复查，并记录了它们随后的病史。在这些涂片中，173份有明确的挖空细胞证据。无论最初的核异质等级如何，在至少21个月的最短随访期内，只有28例（16.2%）有潜在的CIN或进展为CIN。只有2例（1.2%）显示有CINIII的证据。挖空细胞与CIN的低风险相关，尤其是与CINIII的极低风险相关。因此，对有挖空细胞涂片的女性的管理应相应调整。
