意义不明确的非典型鳞状细胞宫颈细胞学诊断的临床意义。倾向于反应性过程或低级别鳞状上皮内病变。

Clinical Significance of a cervical cytologic diagnosis of atypical squamous cells of undetermined significance. Favoring a reactive process or low grade squamous intraepithelial lesion.

作者信息

Gonzalez D, Hernandez E, Anderson L, Heller P, Atkinson B F

机构信息

Department of Obstetrics and Gynecology, Allegheny University, Philidelphia, Pennsylvania 19129, USA.

出版信息

J Reprod Med. 1996 Oct;41(10):719-23.

PMID:9026557

Abstract

OBJECTIVE

To define the clinical significance of qualifying the cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS) as favoring either a reactive process or a low grade squamous intraepithelial lesion (LSIL) in an effort to provide management guidelines.

STUDY DESIGN

A total of 118 consecutive nonpregnant women with a cytological diagnosis of ASCUS favoring either a reactive process or LSIL were evaluated in our colposcopy clinic by repeat cervical cytologic smear, colposcopy and colposcopically directed biopsies and/or endocervical curettage, as indicated.

RESULTS

Of the 58 patients evaluated for a smear of ASCUS, favoring a reactive process, 5 (8.6%) had cervical intraepithelial neoplasia (CIN) CIN 1 documented by biopsy. None had a high grade lesion. Twenty-six (45%) of the 58 patients who had a cytologic diagnosis of ASCUS favoring a reactive process had a repeat smear that was normal. None was found to have CIN. Of the 60 patients who had a cervical diagnosis of ASCUS favoring LSIL, 9 (15%) had CIN 1 or CIN 2. Nineteen (32%) of the 60 patients who had a cytologic diagnosis of ASCUS favoring LSIL had a repeat smear that was normal. One of these patients had CIN 1 on biopsy. The sensitivity of a repeat smear, in this limited series, after an initial smear of ASCUS favoring a reactive process is 100%, while it was 66% after an initial smear of ASCUS favoring LSIL.

CONCLUSION

This study showed that in our laboratory a cytologic diagnosis of ASCUS favoring either a reactive process or LSIL is associated with a very low risk that the patient is haboring CIN. In the patient whose initial smear shows ASCUS favoring a reactive process, a repeat smear that is normal is reassuring. The patient whose smear shows ASCUS favoring LSIL probably requires further evaluation even in the presence of a normal repeat smear.

摘要

目的

明确将意义不明确的非典型鳞状细胞（ASCUS）的细胞学诊断判定为倾向于反应性过程或低级别鳞状上皮内病变（LSIL）的临床意义，以提供管理指南。

研究设计

在我们的阴道镜诊所，对118例连续的非妊娠女性进行了评估，这些女性的细胞学诊断为ASCUS，倾向于反应性过程或LSIL，根据需要进行重复宫颈细胞学涂片、阴道镜检查以及阴道镜引导下活检和/或宫颈管刮除术。

结果

在评估的58例涂片显示ASCUS且倾向于反应性过程的患者中，5例（8.6%）经活检证实有宫颈上皮内瘤变（CIN）1级。均无高级别病变。58例细胞学诊断为ASCUS且倾向于反应性过程的患者中，26例（45%）重复涂片结果正常。未发现有CIN。在60例宫颈诊断为ASCUS且倾向于LSIL的患者中，9例（15%）有CIN 1级或CIN 2级。60例细胞学诊断为ASCUS且倾向于LSIL的患者中，19例（32%）重复涂片结果正常。其中1例患者活检有CIN 1级。在这个有限的系列研究中，最初涂片显示ASCUS且倾向于反应性过程后重复涂片的敏感性为100%，而最初涂片显示ASCUS且倾向于LSIL后重复涂片的敏感性为66%。