不典型鳞状上皮细胞的临床意义及阴道镜再分类的价值

The clinical significance of "atypical squamous cell" and the value of colposcopic diagnosis in reclassification of ASC

目的:探讨不典型鳞状上皮细胞(ASC)在宫颈病变中的临床意义及阴道镜检查对ASC再分类的价值,为临床提供指导和管理依据。方法:对412例细胞学结果为ASC的患者全部进行阴道镜检查及定位活检,以病理学诊断为金标准,计算宫颈病变率及阴道镜拟诊的符合率。结果:ASC中包含了各级宫颈病变,其中CINⅠ为29.6%(122/412),CINⅡ为4.6%(19/412),CINⅢ为1.7%(7/412)。阴道镜诊断和病理学结果有较高一致性,Kappa=0.7(P<0.001)。阴道镜对宫颈病变诊断的敏感度为90.2%(148/164),阴性预测值达92.9%(209/225)。结论:ASC中仍有较高的宫颈病变发生率,阴道镜检查对宫颈病变诊断有较高的预测价值。

Objective： To explore the clinical meaning of ＂ atypical squamous cell ＂ （ASC） diagnosed by thin - prep cytologic test （TCT） and the value of colposcopic in reclassification of ASC. Methods： A total of 412 ASC cases was detected by biopsy under the colposcopy to count incidence rate of cervical lesions and the consistency of diagnose of colposcopy with final pathological diagnosis. Results： Of the 412 women with cytological ASC, 122 （29. 6% ） were CINⅠ, 19 （4. 6% ） were CIN Ⅱ, 7 （ 1. 7% ） were CINⅢ. The diagnose of colposcopy had higher consistency with pathological diagnosis （ Kappa = 0. 7, P 〈 0. 001 ） and the sensitivity and negative predictive value for CIN were 90. 2% and 92. 9% respectively. Conclusion： There are high incidence rate of cervical lesions in ASC eases and the check of eolpnscopy is very valuable to diagnose cervical lesions.