宫颈细胞学检查为ASCUS的临床意义及处理

目的：探讨薄层细胞学技术（TCT）结果为未明确意义不典型鳞状细胞（atypical squamouns cell of undetermined significance,ASCUS）的临床意义及处理方法。方法：对2006年6月～2009年6月北京市顺义区老年妇幼保健院妇科门诊行液基TCT检查结果回报为ASCUS的患者132例均进行阴道镜检查及多点活检,对其结果进行临床及病理分析。结果：132例ASCUS患者活检病理为炎症81例,占61.36%;轻度宫颈上皮非典型增生（CINⅠ）24例,占18.18%;中度宫颈上皮非典型增生（CINⅡ）14例;占10.61%;重度宫颈上皮非典型增生及宫颈原位癌（CINⅢ）11例,占8.33%;浸润癌2例,占1.52%。阴道镜拟诊为宫颈上皮内瘤变（CIN）及浸润癌的灵敏度、特异度、阳性预测值、阴性预测值分别为98.04%、95.06%、92.59%、98.72%。结论：阴道镜对宫颈病变有较高的诊断价值,对ASCUS患者,在基层医院可以直接行阴道镜检查并多点活检行组织病理学检查。

Clinical significance and treatment of cervical cytology as ASCUS

Objective： To investigate the clinical significance and treatment of the thin-cytologic test（TCT） result as atypical squamouns cell of undetermined significance（ASCUS）.Methods： 132 patients from June 2006 to June 2009 were selected to do TCT,the results were ASCUS,132 patients were given colposcopy and multiple punch biopsy,and its results were analyzed.Results： Of the 132 patients,biopsy for the inflammation were 81 cases,accounted for 61.36%;cervical intraepithelial neoplasia Ⅰ（CINI） were 24 cases,accounted for 18.18%;cervical intraepithelial neoplasia II（CINII） were 14 cases,accounted for 10.61%;cervical intraepithelial neoplasia III（CINIII） were 11 cases,accounted for 8.33%;carcinoma were 2 cases,accounted for 1.52%.Colposcopy be diagnosed as cervical intraepithelial neoplasia（CIN） and invasive carcinoma of the sensitivity,specificity,positive predictive value,negative predictive value were 98.04%,95.06%,92.59%,98.72% respectivly.Conclusion： Colposcopy for the diagnosis of cervical lesions has higher value,the ASCUS patients can do colposcopy and biopsy for histopathological multi-point inspection in primary hospital immediately.