宫颈不典型鳞状细胞和腺细胞的临床意义及相关因素的分析

Clinical Significance and Correlation Factor of Untypical Squamous Cells or Glandular Cells of Cervix Found by TCT

目的:探讨超薄液基细胞技术(TCT)结果中,性质不明的不典型鳞状细胞和腺细胞(AS-CUS、AGUS)的临床意义及相关因素。方法:对639例TCT结果为ASCUS、AGUS进行分析总结,ASCUS619例,其中346例进行了阴道镜检查取活检病理诊断,另273例观察3月并对症治疗后复查TCT;AGUS20例进行诊刮术,分别取子宫内膜和子宫颈内膜做病理检查。结果:20～39岁患者宫颈低度鳞状上皮内瘤变(LSIL)和高度鳞状上皮内瘤变(HSIL)发生率多于其他年龄段,临床伴有阴道炎症和肿瘤家族史者的宫颈上皮内瘤变(CIN)Ⅲ发生率比不伴有炎症、无肿瘤家族史者发病率显著增多。围绝经期妇女出现子宫内膜不典型增生及子宫内膜炎者较年轻者多,尤为绝经后为著。结论:临床有阴道炎症和肿瘤家族史是宫颈上皮内瘤样病变的高危因素,围绝经期妇女特别是绝经后出现AGUS是子宫内膜严重疾病的标志,进行诊刮和严密随访是必要的。

Objective：To analyze the clinical significance and correlated factors of untypical squamous cells or glandular cells （ASCUS/AGUS） of cervix found in TCT. Methods：There were 639 cases detected by TCT. In 619 ASCUS cases,346 underwent biopsy under colposcopy, and another 273 case recheck with TCT after three months of follow-up. Diagnostic curettage and histopathologic examination were done in 20 cases of AGUS simultaneously. Results ：＇lhe incidence of LSIL and HSIL in 20 to 39 ages was more than other ages, In women with vaginitis or family tumor history,their occurrence of CIN Ⅲ increased significantly.There was more endornetdal atypical hyperplasia or endometritis in pedmenopausal women, especially in postmenopausal women. Conclusions：The high risk factor for CIN includes vaginitis and family tumor history. AGUS can be a signal of endometrial serious disease in penrne nopausal women,particularly in postmenopausal women that is necessary for diagnostic curettage and follow-up.