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目的 初步评价 2 0 0 1年修订的TBS系统中关于不典型鳞状细胞 (ASC)及其两种亚型 ,即意义不明确的不典型鳞状细胞 (ASC US)和不除外高度上皮内病变的不典型鳞状细胞 (ASC H)诊断标准 (修订标准 )的临床指导意义。方法 对 1186例按TBS系统修订前使用的诊断标准 (修订前标准 ) ,诊断为未明确诊断意义的不典型鳞状上皮细胞 (ASCUS)的宫颈细胞抹片或薄片 (涂片 ) ,以修订标准重新进行诊断 ;对其中 16 8例以细胞学诊断后 6个月内进行的阴道镜下宫颈活组织检查、高频环型电刀切除术的组织病理学检查结果作为标准 ,评价修订标准的细胞学结果。结果 以修订标准重新诊断的 1186例宫颈细胞涂片中 ,宫颈细胞学检查阴性 2 85例 ( 2 4 0 % ) ,ASC US 6 2 7例 ( 5 2 9% ) ,ASC H 2 5 4例 ( 2 1 4 % ) ,低度上皮内病变 (LSIL) 16例 ( 1 3% ) ,高度上皮内病变 (HSIL) 4例( 0 3% )。以修订标准重新诊断、有组织病理学结果的 16 8例中 ,为ASC H、组织病理学结果为宫颈上皮内瘤变 (CIN)Ⅱ、Ⅲ级者为 18 9% ,明显高于ASC US患者的 5 2 % (P <0 0 5 ) ,和以修订前标准诊断的ASCUS( 14 3% )。在 6个月的随诊过程中 ,5例ASC US细胞学检查结果升级 ( 4例为LSIL ,1例为HSIL) ,4例ASC H细胞学检查结果升级 ( 2例为LSIL ,2
OBJECTIVE: To evaluate the clinical significance of atypical squamous cell (ASC) and its two subtypes, the atypical squamous cell of unknown significance (ASC US), and the non-high-grade intraepithelial lesion Of the atypical squamous cell (ASC H) diagnostic criteria (revised standards) clinical significance. Methods Cervical cell smears or sheets (smears) of 1 186 cases of atypical squamous epithelial cells (ASCUS) of undetermined diagnosis were retrospectively analyzed in 1186 cases of pre-revision diagnostic criteria (pre-revision criteria) Re-diagnosis; of which 16 8 cytology diagnosis within 6 months after colposcopic cervical biopsy, high-frequency electrosurgical excision histopathology test results as a criterion to evaluate the revised standard cytology results . Results Of the 1186 cervical smears that were re-diagnosed with the revised standard, 285 (24.0%) were negative for cervical cytology, ASC-US 627 (52.9%), and ASC-H 5 54 16 cases (13%) of low grade intraepithelial lesion (LSIL) and 4 cases (0 3%) of high grade intraepithelial lesion (HSIL). Among the 16 8 cases with histopathological results revising the standard, ASC H had a histopathological result of 18.9% of patients with cervical intraepithelial neoplasia (CIN) Ⅱ and Ⅲ, which was significantly higher than that of ASC US patients (P <0 05), and ASCUS (14 3%) diagnosed according to the pre-revision criteria. During the 6-month follow-up, 5 cases of ASCUS cytology were upgraded (4 cases of LSIL and 1 case of HSIL), and 4 cases of ASC H cytology were upgraded (2 cases were LSIL, 2