CAJ | 학술논문

目的探讨液基薄层细胞学检测(TCT)为不典型上皮细胞患者的临床管理方案.方法回顾性分析TCT检查提示为不典型上皮细胞的956例患者临床资料.患者行阴道镜检查及多点活检,记录宫颈细胞学、阴道镜检查、组织病理学结果及高危因素.以组织病理学诊断为金标准进行统计分析,计数资料用X~2检验,并计算危险度OR值(odds ratio,比数比).结果阴道镜下多点活检,病理结果为宫颈上皮内瘤变(CIN)的比例50.7% ,CINII以上病变的比例为13.3% ;而阴道镜检查提示低度病变,组织病理学提示CINII以上的高度病变的比例为8.3% ;宫颈高度病变的高危因素包括性伴数超过3个,初次性生活年龄<20岁,宫颈糜烂史,TCT结果为ASC-H.结论 TCT为不典型上皮细胞的患者中,组织病理学结果多样性,CIN及宫颈高度病变的比例仍很高;TGT为不典型细胞,建议直接行阴道镜检查,对有高危因素的患者建议行多点活检,避免漏诊.
목적 탐토액기박층세포학검측(TCT)위불전형상피세포환자적림상관리방안.방법 회고성분석TCT검사제시위불전형상피세포적956례환자림상자료.환자행음도경검사급다점활검,기록궁경세포학、음도경검사、조직병이학결과급고위인소.이조직병이학진단위금표준진행통계분석,계수자료용X~2검험,병계산위험도OR치(odds ratio,비수비).결과 음도경하다점활검,병리결과위궁경상피내류변(CIN)적비례50.7% ,CINII이상병변적비례위13.3% ;이음도경검사제시저도병변,조직병이학제시CINII이상적고도병변적비례위8.3% ;궁경고도병변적고위인소포괄성반수초과3개,초차성생활년령<20세,궁경미란사,TCT결과위ASC-H.결론 TCT위불전형상피세포적환자중,조직병이학결과다양성,CIN급궁경고도병변적비례잉흔고;TGT위불전형세포,건의직접행음도경검사,대유고위인소적환자건의행다점활검,피면루진.
Objective To analyze the clinical management of women with atypital squamous cells(ASC).Methods During Sep 2003 to Sep 2008,a totle of 956 women in our department were diagnosed with ASC by cytological test,they were further biopsied under the colposcope.The result of TCT,colposcopic test,biopsy and the highrisk factor were recorded and analysed;the based the biopsy were analyzed by the X~2-test;the high-risk factors and the odds Ratio(OR) were counted by SPSS10.0.Results Among the women with ASC,the rate of cervical intraepithelial neoplasia(CIN) diagnosed by the biopsy under the colposcope was 50.7% ,the rate of the high-grade lesion over CINII Was 13.3% ;if the colposcopic test were low-grade lesion,the rate of the cases which biopsys were the highgrade lesion over CINII,was 8.3% ;the high-risk factors which caused the cervical high-grade lesion were the number of sex-partners over 3,the age less than 20 yearold when the sex were made,the cervical erosion,the result of TCT with ASC-H.Conclusion Among the women with ASC,the biopsy shows multiformity;the rate of CIN and the highgrade lesion is also high;if TCT is ASC,the colposcopie test is advised;if the woman who has the high-risk factors,biopsy is advised.