绝经妇女宫颈液基细胞学ASCUS的转归情况分析

Outcome analysis of ASCUS by cervical thin-prep cytology test in postmenopausal women

目的探讨绝经妇女宫颈液基细胞学不能明确意义的非典型鳞状宫颈上皮细胞(ASCUS)的转归特点。方法选择2013年1月—2014年12月瑞安市中医院TCT结果为ASCUS女性712例为研究对象,根据是否绝经分为绝经组和未绝经组,观察绝经组和未绝经组TCT检查结果、ASCUS检出率、ASCUS以上级别病变检出率、ASCUS转归情况及ASCUS的转归和人乳头瘤状病毒(HPV)感染的相关性。结果绝经组ASCUS的检出率低于未绝经组,但差异无统计学意义(P>0.05);绝经组宫颈鳞状上皮内病变的检出率低于未绝经组(P<0.05),绝经组宫颈癌的检出率高于未绝经组(P<0.05);绝经组和未绝经组女性ASCUS的转归情况比较差异具有统计学意义(P<0.05),绝经组转归为高级别病变和宫颈鳞状细胞癌的比例高于未绝经组,转归为良性病变的比例低于未绝经组;绝经组ASCUS转归为高级别病变合并HPV感染者22例,21例为HPV高危感染,转归为宫颈鳞状细胞癌者9例,均为高危型HPV感染;未绝经组ASCUS转归为高级别病变合并HPV感染者15例,均为HPV高危感染,转归为宫颈鳞状细胞癌者9例,均为高危型HPV感染。结论绝经女性ASCUS的检出率低,但转归为高级别病变和宫颈癌的几率高于未绝经女性,且转归情况和高危HPV感染关系密切。

Objective To explore the outcome of cervical atypical squamous cells of undetermined significance（ASCUS） in postmenopausal women. Methods Between January,2013 and December,2014,712 cases of ASCUS by thin-prep cy- tology test（TCT） in Ruian City Hospital were enrolled and divided into postmenopausal group and premenopausal group. TCT results, positive rate of ASCUS and high-grade TCT, outcome of ASCUS, and the correlation of ASCUS outcome and HPV infection were observed in both groups. Results The positive rate of ASCUS in the postmenopausal group was lower than that of premenopausal group, but the difference was not statistically significant （ P 〉 0.05 ） ; the positive rate of cervi- cal squamous intraepithelial lesion in the postmenopausal group was lower than that of the premenopausal group （P 〈 0.05 ）, the positive rate of cervical cancer in postmenopausal group was higher than that of premenopausal group （P 〈 0.05 ） ; and the different of ASCUS outcome between the postmenopausal group and premenopausal group women was sta- tistically significant（ P 〈 0.05 ） ,the proportion of high-grade lesions and cervical squamous cell carcinoma in the postm- enopausal group were higher than that of the premenopausal group, the proportion of benign in postmenopausal group was lower than that of premenopausal group;In the postmenopausal group,22 cases of ASCUS developed a high-level disease associated with HPV infection,in which 21 cases were high-risk HPV infection;9 cases developed a cervical squamous cell carcinoma, and all of them were with high-risk HPV infection. In the premenopausal group, 15 cases of ASCUS devel- oped a high-level disease combined with HPV infection, all 15 cases were with high-risk HPV infection ;9 cases developed a cervical squamous cell carcinoma combined with HPV infection, all 9 cases were with high-risk HPV infection. Conclu- sion The positive rate of ASCUS in postmenopausal women is lower, but ASCUS developing high-level lesions and cervi- cal cancer is higher as compared with the premenopausal women, and the ASCUS outcome are closely related to high-risk HPV infection.