González Sánchez J L, Pérez Guerrero C, Celorio Aguilera G, Chávez Barambila J, Ríos Montiel F A
Hospital de Gineco Obstetricia Luis Castelazo Ayala Instituto Mexicano del Seguro Social, Mex, D.F.
Ginecol Obstet Mex. 1998 Aug;66:330-4.
Bethesda system is useful in the citologic diagnosis of premalign diseases of cervix. It was determined the correlation between citologic report using Bethesda system and combined colposcopic index (CCI) or Reid, to diagnose premalign diseases of cervix by histologic diagnostic of punch biopsy by colposcopy. A total of 118 patients come to the colposcopy clinic having smear anormal citology to cervical intraepithelial neoplasia (CIN), only o associated to HPV. It was taken to all of them a new cervical smear, colposcopy and punch biopsy. We analized the findings for citology with Bethesda system and colpospic with CCI of Reid, using histologic diagnosis of punch biopsy by colposcopy. Diagnosis correlation between Bethesda system and the punch biopsy by colposcopy was 98.5% for 82 patients with low grade squamous intraepithelial lesions with a concordance of 100% for HPV and 97% for CNI I (p < 0.05). In the other hand 92% from 36 patients classified as high grade squamous intraepithelial lesions with a concordance of 84% to CIN II and 100% to CIN III (p < .05) Sensibility of 93%, especifidad and positive predictive value of 96% and negative predictive value of 98%. We conclude correlation between citologic report with Bethesda system and the Combined Colposcopic Index of Reid which are effective to diagnose premalign disease of cervix.
贝塞斯达系统在宫颈癌前病变的细胞学诊断中很有用。通过阴道镜下活检的组织学诊断，确定了使用贝塞斯达系统的细胞学报告与联合阴道镜指数（CCI）或里德指数之间的相关性，以诊断宫颈癌前病变。共有118例患者因宫颈细胞学涂片异常至阴道镜门诊，诊断为宫颈上皮内瘤变（CIN），仅与HPV相关。对所有患者进行了新的宫颈涂片、阴道镜检查和活检。我们使用阴道镜下活检的组织学诊断，分析了贝塞斯达系统的细胞学检查结果以及里德CCI的阴道镜检查结果。对于82例低级别鳞状上皮内病变患者，贝塞斯达系统与阴道镜下活检之间的诊断相关性为98.5%，HPV一致性为100%，CNI I一致性为97%（p<0.05）。另一方面，36例被归类为高级别鳞状上皮内病变的患者中，92%与CIN II的一致性为84%，与CIN III的一致性为100%（p<.05），敏感性为93%，特异性和阳性预测值为96%，阴性预测值为98%。我们得出结论，贝塞斯达系统的细胞学报告与里德联合阴道镜指数之间的相关性对诊断宫颈癌前病变有效。
