不典型鳞状上皮细胞的临床意义及阴道镜再分类的价值

目的:探讨不典型鳞状上皮细胞(ASC)在宫颈病变中的临床意义及阴道镜检查对ASC再分类的价值,为临床提供指导和管理依据。方法:对412例细胞学结果为ASC的患者全部进行阴道镜检查及定位活检,以病理学诊断为金标准,计算宫颈病变率及阴道镜拟诊的符合率。结果:ASC中包含了各级宫颈病变,其中CINⅠ为29.6%(122/412),CINⅡ为4.6%(19/412),CINⅢ为1.7%(7/412)。阴道镜诊断和病理学结果有较高一致性,Kappa=0.7(P<0.001)。阴道镜对宫颈病变诊断的敏感度为90.2%(148/164),阴性预测值达92.9%(209/225)。结论:ASC中仍有较高的宫颈病变发生率,阴道镜检查对宫颈病变诊断有较高的预测价值。

The clinical significance of"atypical squamous cell"and the value of colposcopic diagnosis in reclassification of ASC

Objective:To explore the clinical meaning of "atypical squamous cell "(ASC)diagnosed by thin-prep cytologic test(TCT)and the value of colposcopic in reclassification of ASC.Methods:A total of 412 ASC cases was detected by biopsy under the colposcopy to count incidence rate of cervical lesions and the consistency of diagnose of colposcopy with final pathological diagnosis.Results:Of the 412 women with cytological ASC,122(29.6%)were CINI,19(4.6%)were CINⅡ,7(1.7%)were CINⅢ.The diagnose of colposcopy had higher consistency with pathological diagnosis(Kappa=0.7,P<0.001)and the sensitivity and negative predictive value for CIN were 90.2% and 92.9% respectively.Conclusion:There are high incidence rate of cervical lesions in ASC cases and the check of colposcopy is very valuable to diagnose cervical lesions.