Objective: To study the clinical management strategy of atypical squamous cells of undeter mined significance (ASCUS) diagnosed by cervical liquid-based cytology test (LCT).Methods :454 ASCUS were found by LCT and were divided into 3 groups randomly.151 ASCUS in group A,had repeated LCT in 3 month; 152 ASCUS in group B, had high-risk human papilloma virus (HPV) testing immediately ; 151 ASCUS in group C,had colposcopy and biopsy immediately.The detection of cervical intraepithelial neoplasia(CIN) in the three groups was analyzed.Results: ①In group A,there were 39 (25.83％) abnormal results after repeated LCT(≥ASCUS).For the 39 patients, their pathology results by biopsy under colposcopy were 24 cervicitis,5 CIN Ⅰ ,9 ClN Ⅱ ,1 CIN Ⅲ.For the other 95 normal results,88 cervicitis,4 CIN Ⅰ ,2 CIN Ⅱ ,1 CIN Ⅲ were found by colposcopy.②In group B,60(39.47％ ) patients had positive HPV test result,their pathology results by biopsy under colposcopy were 32 cervicitis,13 CIN Ⅰ ,13 CIN Ⅱ ,2 CIN Ⅲ.No CN was found when HPV test was negative.③In group C, the biopsy results were 115 cervicitis, 12 ClN Ⅰ , 18 ClN Ⅱ ,6 CIN Ⅲ.④To detect the high grade ClN by repeated LCT or high-risk HPV testing,there was no statistical difference (P ＞ 0.05).Conclusions:Repeated LCT is efficient in triage of ASCUS.For the women without obliability or having high risk factors, HPV testing or colposcopy and biospy is necessary.%目的:探讨宫颈液基细胞学检查(LCT)结果为未明确诊断意义的不典型鳞状上皮细胞(ASCUS)的临床处理方法.方法:LCT检查结果为ASCUS的患者454例,将其随机分为3组:A组,151例,3月后复查LCT;B组,152例,随即进行高危型人乳头瘤病毒(HPV)检测:C组.151例,随即进行阴道镜检查,并在阴道镜下活检.比较3组ASCUS患者宫颈上皮内瘤变(CIN)的检出情况.结果:①A组复查LCT,细胞学异常(≥ASCUS)39例(25.83%),阴道镜下活检病理结果为宫颈炎24例,CINⅠ5例,CINⅡ9例,CINⅢ1例.95例复查LCT正常者阴道镜下活检,病理结果为宫颈炎88例,CINⅠ4例,CINⅡ2例,CINⅢ1例.②B组有60例(39.47%)高危型HPV检测阳性,其阴道镜下活检病理结果为宫颈炎32例,CINⅠ13例,CINⅡ13例,CINⅢ2例.80例HPV阴性者阴道镜下活检,病理均为宫颈炎.③C组151例ASCUS直接进行阴道镜检查及阴道镜下活检,病理结果为宫颈炎115例,CINⅠ12例,CINⅡ18例.CINⅢ6例.④复查LCT和检测高危型HPV对预测ASCUS患者中宫颈高级别病变的准确性差异无统计学意义(P＞0.05).结论:复查LCT是有效的分流ASCUS的方法.对于依从性差或高危人群,宜作高危型HPV检测进行分流,或直接行阴道镜检查及镜下活检明确诊断,随即作相应处理.
展开▼
