阴道镜检查在ASC-US患者分层管理中的作用资料.docVIP

阴道镜检查在ASC-US患者分层管理中的作用 【摘要】目的：探查电子阴道镜检查在宫颈细胞学意义未明的不典型鳞状细胞(atypical squamous cell of undermind significance，ASC-US)患者分层管理中的作用。方法：对2007年10月～2009年10月在海南医学院附属医院门诊行宫颈液基薄层细胞学检查(TCT)，结果判读为ASC-US，并接受电子阴道镜检查的患者438例，进行分析和总结。438例患者均进行阴道镜评估，其中223例拟诊为宫颈上皮内瘤变(cervical intraepithelial neoplasia，CIN)及以上病变者行镜下活检，送病理。215例阴道镜拟诊为正常或炎症者给予抗感染治疗后，第6个月复查TCT ,3例TCT结果仍为ASC-US，即进行阴道镜下活检;余212例细胞学阴性者转入常规细胞学筛查队伍中。结果：438例ASC-US患者中，进行阴道镜评估病理检查226例(51.60%)，检出CIN Ⅰ 91例，CIN Ⅱ 29例，CIN Ⅲ 17例，宫颈癌4例，余212例进行电子阴道镜检查评估，避免了活体组织检查的损伤，随访12个月复查TCT未发现异常。结论：电子阴道镜检查在ASC-US患者分层处理中有意义，可有效检出CIN及以上病变，可作为基层医院对ASC-US患者进行分层处理的方法。 【关键词】 宫颈上皮内瘤变;宫颈癌;意义未明的不典型鳞状细胞;电子阴道镜;宫颈液基薄层细胞学检查 [ABSTRACT] Objective： To explore the use of electronic colposcopy test in treatment of patients presented with atypical squamous cell of undermind significance (ASC-US). Methods： Data of 438 presented with ASC-US according to thin-prep cytologic test (TCT) who were willing to undergo electronic colposcopy test were retrospectively analyzed. Samples were collected from 223 patients that were diagnosed as cervical intraepithelial neoplasia (CIN) under electronic colposcopy for pathological examination. Other 215 cases that were diagnosed as health or only need antibiotic treatments underwent TCT again six months later， 3 cases that showed ASC-US were put through biopsy; the rest 212 cases that showed negative cytology results were classified as those need to undergo routine cytologic screening. Results： Of the 226 patients (51.60%) that underwent electronic colposcopy test， 91 were diagnosed as CIN Ⅰ， 29 as CIN Ⅲ， 17 as CIN Ⅲ and 4 were cervical cancer. The rest 212 patients that showed negative results avoided biopsy injuries since TCT results remained normal after 12 months. Conclusions： Electronic colposcopy is an important method for the level administration of patients with ASC-US， it can show CIN or worse pathological changes， thus can be applied in primary hospitals. [KEY WORDS] Cervical intraepithelial neoplasia; Carcinom