宫颈细胞学ASC-H的临床意义及管理

The clinical significance and management of cervical cytological ASC-H

目的探讨宫颈非典型鳞状上皮细胞（ASC）不除外高度病变（ASC-H）的临床意义及管理。方法回顾性分析成都市妇女儿童中心医院2013-2015年间用宫颈液基细胞学（LCT）方法检出的137例ASC-H,对比其阴道镜检查、组织学结果,初步分析其临床意义及各年龄段发现CINⅡ及以上病变的几率。结果在137例ASC-H病例中,阴道镜检查发现42例高度及以上病变,组织学显示：低度及以下病变55例,高度及以上病变82例;30～50岁之间组织学发现高度及以上病变的几率最高,60岁以上病变的几率最低。结论宫颈细胞学ASC-H具有较高的高度上皮内病变（HSIL）预测值,对ASC-H阴性病例应给予高度关注及恰当的处理。

Objective To explore the clinical significance and management of cervical ASC-H（ atypic squamous epitheilal cell,not exclude high-grade lesion）. Methods Retrospective analysis was used,137 cases diagnosed as ASC-H from 2013 to 2015 were performed and cervix uteri liquid based cytology was used to diagnose ASC-H. The preliminary clinical significance was analyzed based on the histological diagnosis and colposcopy results,and to analyze the incidence of CINⅡ ＋ according to different ages. Results Of the 137 cases of ASC-H,42 cases were diagnosed as CINⅡ ＋ by colposcopy; and the histological results showed 55 cases of CINⅠ-,82 cases of CINⅡ ＋,and women between 30 and 50 years old had the highest risk of CINⅡ ＋,women over 60 years old had the lowest incidence. Conclusions Cervical Cytological ASC-H have a good predicted value of HSIL,and we should pay more attention to the patients who were diagnosed as ASC-H without histological high-grade lesion immediately,and take treatment properly.