绝经后妇女宫颈不典型鳞状细胞特点及转归

目的 探讨绝经后妇女的超薄液基细胞技术（TCT）结果中性质不明的不典型鳞状细胞（ASCUS）的特点及转归。方法 对198例绝经后妇女的TCT结果为ASCUS者进行分析总结，96例直接进行了阴道镜检查取活检病理诊断，102例先观察3月后复查TCT。阴道镜活检病理结果为宫颈上皮内瘤变（CIN）和复查TCT结果仍为ASCUS的行二代杂交捕获（HC2）实验，检测人乳头瘤病毒（HPV）-DNA。结果 ①96例阴道镜检查取活检病理诊断为CIN的19例（Ⅰ级12例，Ⅱ级7例），7例CINⅡ级行宫颈锥切后3月复查TCT为正常；②102例观察3月再复查TCT持续为ASCUS的18例，2例宫颈低度鳞状上皮内瘤变（LSIL），二者的异常率比较无统计学差异（P〉0．05）；③阴道镜检查活捡病理为CIN和TCT持续为ASCUS的共39例，进行HC2HPV—DNA检测结果均为阳性。结论 绝经后妇女的ASCUS特点是宫颈病变的比率低，表明其转归较好；有宫颈病变的老年患者均感染HPV，提示ASCUS中的绝经后妇女HPV的检测及治疗对于预防老年宫颈癌发生有重要意义。

Characteristics and prognosis of cervical atypical squamous cells in postmenopausal women

Objective To investigate the characteristics and prognosis of atypical squamous cells of undetermined significance（ASCUS） by thinprep cytologinic test （TCT） in postmenopausal women. Methods Analysis was carried on 198 postmenopausal women with a TCT resuh of ASCUS. 96 of them were directly examined by colposcopy. 102 women were reexamined by TCT after 3 months. Human papilloma virus（HPV） DNA were detected with hybrid capture Ⅱ （HC- Ⅱ ）. In 39 women, the resuhs of the biopsy obtained by colposcopy were cervical intra-epithelial neoplasia（CIN） and the results of TCT were still ASCUS. Results ①In the 96 women who received biopsy by colposcopy, 19 cases were diagnosed to be CIN （CIN Ⅰ 12 cases,CIN Ⅱ 7 cases）. The results of 7 women of CIN Ⅱ reexamined by TCT were normal 3 months after conization of cervix. ②18 of 102 women reexamined by TCT after 3 months of observation remained to be ASCUS. Two cases presented with low-grade squamous intraepithelial lesion （LSIL）. The rate of abnormality had no significant difference between two groups （ P 〉 0. 05 ） ; ③Thirty-nine cases presented with CIN or ASCUS. The results of HC2 HPV-DNA of these patients were positive. Conclusious The characteristics of ASCUS in postmenopausal women is that the rate of cervix diseases is low,and the prognosis of ASCUS is good. All senile patients who had cervical diseases were infected by HPV,which suggests that detection and therapy of HPV infection is important to prevent senile cervical diseases for ASCUS in postmenopausal women.