宫颈不典型鳞状上皮细胞的临床诊治探讨

目的探讨液基细胞学检查（TCT）结果为宫颈不典型鳞状上皮细胞（ASCUS）的诊疗处理方案。方法随机抽取400例ASCUS患者，平均分为两组，一组于3个月后复查TCT，后行HR—HPVDNA检测和阴道镜检查；另一组即刻行HR—HPVDNA检测和阴道镜检查，比较3个月后复查TCT、HR—HPVDNA检测、阴道镜及镜下活检三种方法对ASCUS患者管理的临床诊治意义。结果①A组复查TCT，124例细胞异常者阴道镜下活检病理为宫颈癌1例，CINII～III级31例，CINI级48例，慢性宫颈炎44例，76例细胞正常者阴道镜下活检病理为CINII～III级1例，CINI级2例，慢性宫颈炎73例。②A组行HR—HPVDNA检测，结果132例阳性患者中，宫颈癌1例，CINII—III级32例，CINI级50例，慢性宫颈炎49例，68例阴性患者的病理结果均为慢性炎症。③B组HR—HPVDNA检测结果121例阳性患者中CINII～III级44例，CINI级50例，慢性宫颈炎27例，79例阴性患者的病理结果均为慢性炎症。结论采用个性化处理，本文倾向于在各方面条件允许的情况下，首选HR—HPVDNA检测分流，对阳性结果患者进行阴道镜下活检或诊断性LEEP。

Study on the clinical diagnosis and treatment of atypical squamous cells of underminded significance

Objective To study the clinical management strategy of atypical squamous cells of undetermined significance（ASCUS） diagnosed by thinprep cytologic test（TCT）. Methods 400 ASCUS were found by TCT and were divided into 2 groups randomly. 200 ASCUS in group A,had repeated TCT after 3 month,then had high-risk human papilloma virus（HPV） testing and colposcope. 200 ASCUS in group B, had HPV testing and colposcope immediately. The detection of cervical intraepithelial neoplasia was analyzed by three methods. Results ① In group A, there were 124 abnormal results after repeated TCT（≥ASCUS）. For the 124 patients, their pathology results by biopsy under colposcopy were 1 cervical carcinoma,31 CIN II-III,48 CIN I, 44 cervicitis. For the other 76 normal results, 1 CIN II-III, 2 CIN I, 73 cervicitis were found by colposcopy. ② In group A,132 patients had positive HPV result, their pathology results by biopsy under coIposcopy were 1 cervical carcinoma, 32 CIN II-III, 50 CIN I, 49 cervicitis. The other 68 patients had negative HPV result were cervicitis. ③ In group B, 121 patients had positive HPV result, their pathology results by biopsy under colposcopy were 44 CIN II-III, 50 CIN I, 27 cervicitis. The other 79 patients had negative HPV result were cervicitis. Conclusion This paper tends to the preferred HR-HPV DNA shunt detection in various conditions allowed, the patients with positive results undergo colposcopy biopsy or diagnostic LEEP.