巴氏涂片异常者宫颈病变的发生率及预测

目的评估巴氏涂片未明确意义的非典型鳞状细胞(ASCUS)和低度鳞状上皮内病变(LSIL)者的宫颈病变的发生率及确定临床预测指标。方法回顾性分析了406例ASCUS和LSIL的患者的有关资料,所有患者行阴道镜检查,采用多因素logistis回归分析以确定预测组织学LSIL和高度鳞状上皮内病变(HSIL)的指标。结果406例中有137例(34%)为组织学鳞状上皮内病变(SIL)。组织学SIL和低度鳞状上皮内病变(HSIL)的预测指标为年龄(<35岁及≥35岁)和初次涂片结果(LSIL及ASCUS),P<0.001,进行回归分析。结论在异常巴氏涂片中有宫颈病变高危因素者立即行阴道镜检查是适宜的。年龄和初次巴氏涂片是预示宫颈病变的因素并可用于选择低危险度的患者。

Incidence and prediction of cervical dysplasia in the patients showed minimally abnormal Papanicolaou smears

Objective To estimate the incidence of dysplasia in patients showed Papanicolaou smears of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions(LSIL) and to identify clinical predictors of dysplasia in these patients. Methods Patients referred for ASCUS and LSIL were reviewed retrospectively.All the patients were evaluated with immediate colposcopy. A multivariate logistic regression analysis was performed to identify clinical predictors of histologic LSIL and HSIL(i.e. high-grade SIL).Results 137 (34%) of 406 consecutive patients had histologic SIL. Regression analysis identified age(under 35 versus 35 years or above)and initial smear(low-grade SIL versus ASCUS) as statistically significant predictors of histologic SIL and HSIL(P<0.001).Conclusion The high incidence of dysplasia in patients showed minimally abnormal Papanicolaou smears suggests that immediate colposcopy might be appropriate for many of these patients.Age and initial Papanicolaou smear are predictive of dysplasia and might be used to select patients who have low incidence of dysplasia and might not require immediate colposcopy.