Frauchiger W L, De Frias D V, Cajulis R S, Yu G H
Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois, USA.
Acta Cytol. 1998 Sep-Oct;42(5):1139-43. doi: 10.1159/000332102.
To determine the diagnostic value of obtaining an endocervical smear for cytologic examination immediately following cervical conization (by either the loop electrosurgical excision procedure or large loop excision of the transformation zone) in the detection of residual squamous dysplasia.
Thirty-eight cases were identified in which cervical conization was immediately followed by endocervical sampling (most commonly using a brush) and smear.
Twenty-one of the 38 postconization endocervical smears (55%) were either unsatisfactory or sub-optimal for evaluation due to cellular distortion (i.e., cautery artifact), degeneration or obscuring blood. Histologic in evaluation showed negative endocervical margins in 32 cases (84%) and positive endocervical margins in 6 cases (16%), including both low and high grade squamous intraepithelial lesions. The endocervical smears in the 32 cases with a negative surgical margin did not demonstrate evidence of dysplasia. However, in the six cases with histologically positive margins, postconization endocervical smears also failed to identify any evidence of dysplasia.
Immediate postconization endocervical smears do not appear to be useful for the detection of residual disease in patients undergoing conization for squamous dysplasia of the cervix.
确定在宫颈锥切术（采用环形电切术或转化区大环形切除术）后立即获取宫颈管涂片进行细胞学检查在检测残留鳞状上皮发育异常中的诊断价值。
确定了38例病例，这些病例在宫颈锥切术后立即进行宫颈管取样（最常用刷子）和涂片。
38例锥切术后宫颈管涂片中，有21例（55%）因细胞变形（即烧灼伪像）、退变或血液遮盖而评估不满意或欠佳。组织学评估显示32例（84%）宫颈管切缘阴性，6例（16%）宫颈管切缘阳性，包括低级别和高级别鳞状上皮内病变。32例手术切缘阴性的病例中，宫颈管涂片未显示发育异常的证据。然而，在6例组织学切缘阳性的病例中锥切术后宫颈管涂片也未发现任何发育异常的证据。
对于因宫颈鳞状上皮发育异常而接受锥切术的患者，锥切术后立即进行宫颈管涂片似乎无助于检测残留疾病。
