CAJ | 학술논문

目的对比研究宫颈病变细胞学和组织学诊断在不同年龄组中的特点,寻求临床科学管理方法.方法回顾分析2003年5月-2008年8月细胞学诊断低度鳞状上皮内病变(LSIL)并行阴道镜下活检和(或)子宫颈环切术(LEEP)病例,年龄分层后对比细胞学、组织学诊断符合情况. 结果 549例LSIL,高危型人乳头状瘤病毒(HR-HPV)感染率53.6%,≤50岁组感染率为54.5%显著高于＞50岁组的31.8%(P＜0.05);细胞学与活检组织学诊断符合率为56.6%,≤50岁组的诊断符合率为57.7%显著高于＞50岁组的31.8%(P＜0.05);高等级宫颈上皮内瘤变(CIN2以上)57例(10.4%),全部发生于＞30岁妇女;LEEP38例,其组织学诊断与阴道镜活检组织学诊断符合7例(25.9%),其中≤30岁组符合率为71.4%显著高于＞30岁组的10.0%(P＜0.01).结论与组织学诊断对比,细胞学诊断LSIL对≤50岁妇女准确性较高;阴道镜对＞30岁妇女的CIN易漏诊;30岁以上妇女是宫颈癌高风险人群.在宫颈癌前病变管理中应充分考虑妇女年龄因素.
목적 대비연구궁경병변세포학화조직학진단재불동년령조중적특점,심구림상과학관리방법.방법 회고분석2003년5월-2008년8월세포학진단저도린상상피내병변(LSIL)병행음도경하활검화(혹)자궁경배절술(LEEP)병례,년령분층후대비세포학、조직학진단부합정황. 결과 549례LSIL,고위형인유두상류병독(HR-HPV)감염솔53.6%,≤50세조감염솔위54.5%현저고우＞50세조적31.8%(P＜0.05);세포학여활검조직학진단부합솔위56.6%,≤50세조적진단부합솔위57.7%현저고우＞50세조적31.8%(P＜0.05);고등급궁경상피내류변(CIN2이상)57례(10.4%),전부발생우＞30세부녀;LEEP38례,기조직학진단여음도경활검조직학진단부합7례(25.9%),기중≤30세조부합솔위71.4%현저고우＞30세조적10.0%(P＜0.01).결론 여조직학진단대비,세포학진단LSIL대≤50세부녀준학성교고;음도경대＞30세부녀적CIN역루진;30세이상부녀시궁경암고풍험인군.재궁경암전병변관리중응충분고필부녀년령인소.
Objective To study the characteristics of cytology and histopathology diagnoses in uterine cervical disease in different age group woman and seek for scientific management.Methods 549 cases of LSIL (Low-Grade Squamous Intraepithelial Lesion) were retrospectively investigated,who had been diagnosed with liquid-based cytology method and underwent colposcopic punch biopsies,and 8 of whom underwent LEEP(loop electro-excisional procedure).The results from cytology and histopathology diagnosis were compared based on different ages.Results Of the 549 patients the HR-HPV infection rate was 53.6%.The rate in the ≤50 and ＞50 age group was respectively 54.5% and 31.8% which showed significant difference (P＜0.05).Coincidence rate of cytology and punch biopsy histopathology diagnosis results was 56.6%.The coincidence rate in the ≤50 and ＞50 age group was 57.7% and 31.8% respectively which showed significant difference too (P＜0.05).57(10.4%)cases of CIN2 (cervical intraepithelial neoplasia grade 2) and above which occurred in ＞30 age group women. The coincidence rate of punch biopsy and LEEP was 25.9%. the coincidence rate in ≤30 and ＞30 age groups was respectively 71.4% and 10.0% which showed significant difference (P＜0.01).Conclusions Compared with the histopathology diagnosis based on colposcopic punch biopsies,cytology diagnosis is more accurate in ≤50 age women with LSIL.Colposcopy is apt to miss CIN and above diagnosis in ＞30 age women who are at high risk of contracting cervical cancer. Woman ages should be taken into full consideration in management of cervical cancer precursor lesions.