中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
27期
46-48
,共3页
未明确诊断意义的不典型鳞状细胞%阴道镜%宫颈癌前病变%宫颈转化区%人乳头瘤病毒
未明確診斷意義的不典型鱗狀細胞%陰道鏡%宮頸癌前病變%宮頸轉化區%人乳頭瘤病毒
미명학진단의의적불전형린상세포%음도경%궁경암전병변%궁경전화구%인유두류병독
ASCUS%Colposcope%Cervical intraepithelial neoplasia%Cervical transformation zone%HPV
目的：探讨宫颈细胞学诊断ASCUS患者的临床处理原则。方法：回顾性分析2009年6月-2011年6月因宫颈细胞学诊断为ASCUS在济南市妇幼保健院行阴道镜检查加活检196例患者的临床资料，根据病理结果将患者分为四组：正常组、HPV感染组、宫颈上皮内瘤变1级（CIN1）组、宫颈癌及高度病变（CIN2-3/SCC）组，对各组的临床特征、病史、阴道镜下宫颈转化区分型及病理结果进行分析。结果：（1）正常组患者48例（24.49%），HPV感染组患者56例（28.57%），CIN1组患者52例（26.53%），CIN2-3/SCC组患者40例（20.41%）。CIN2-3/SCC组中性交出血、多性伴、过早性生活、有主/被动吸烟、低文化的发生率明显高于前三组；（2）不同类型宫颈转化区患者罹患高度宫颈癌前病变及宫颈癌的几率：Ⅰ型18例（19.78%）、Ⅱ型15例（23.08%）、Ⅲ型7例（17.50%），比较差异有统计学意义（P<0.05），其中Ⅱ型转化区最高。结论：对ASCUS患者的处理应强调个体化，高危因素多，经济条件低下、不能做到随访的首选阴道镜检查，转化区Ⅲ型者可首选HPV分流。
目的：探討宮頸細胞學診斷ASCUS患者的臨床處理原則。方法：迴顧性分析2009年6月-2011年6月因宮頸細胞學診斷為ASCUS在濟南市婦幼保健院行陰道鏡檢查加活檢196例患者的臨床資料，根據病理結果將患者分為四組：正常組、HPV感染組、宮頸上皮內瘤變1級（CIN1）組、宮頸癌及高度病變（CIN2-3/SCC）組，對各組的臨床特徵、病史、陰道鏡下宮頸轉化區分型及病理結果進行分析。結果：（1）正常組患者48例（24.49%），HPV感染組患者56例（28.57%），CIN1組患者52例（26.53%），CIN2-3/SCC組患者40例（20.41%）。CIN2-3/SCC組中性交齣血、多性伴、過早性生活、有主/被動吸煙、低文化的髮生率明顯高于前三組；（2）不同類型宮頸轉化區患者罹患高度宮頸癌前病變及宮頸癌的幾率：Ⅰ型18例（19.78%）、Ⅱ型15例（23.08%）、Ⅲ型7例（17.50%），比較差異有統計學意義（P<0.05），其中Ⅱ型轉化區最高。結論：對ASCUS患者的處理應彊調箇體化，高危因素多，經濟條件低下、不能做到隨訪的首選陰道鏡檢查，轉化區Ⅲ型者可首選HPV分流。
목적：탐토궁경세포학진단ASCUS환자적림상처리원칙。방법：회고성분석2009년6월-2011년6월인궁경세포학진단위ASCUS재제남시부유보건원행음도경검사가활검196례환자적림상자료，근거병리결과장환자분위사조：정상조、HPV감염조、궁경상피내류변1급（CIN1）조、궁경암급고도병변（CIN2-3/SCC）조，대각조적림상특정、병사、음도경하궁경전화구분형급병리결과진행분석。결과：（1）정상조환자48례（24.49%），HPV감염조환자56례（28.57%），CIN1조환자52례（26.53%），CIN2-3/SCC조환자40례（20.41%）。CIN2-3/SCC조중성교출혈、다성반、과조성생활、유주/피동흡연、저문화적발생솔명현고우전삼조；（2）불동류형궁경전화구환자리환고도궁경암전병변급궁경암적궤솔：Ⅰ형18례（19.78%）、Ⅱ형15례（23.08%）、Ⅲ형7례（17.50%），비교차이유통계학의의（P<0.05），기중Ⅱ형전화구최고。결론：대ASCUS환자적처리응강조개체화，고위인소다，경제조건저하、불능주도수방적수선음도경검사，전화구Ⅲ형자가수선HPV분류。
Objective:To explore the clinical treatment principle of patients with ASCUS. Method:To retrospectively analyze the clinical data of 196 patients with vaginoscopy and biopsy for the cervical cytological diagnosis of ASCUS during June 2009-June 2011 in Jinan Maternity And Child Care Hospital. According to the results of pathology,the patients could be divided into four groups:normal group,HPV infection group,cervical intraepithelial neoplasia grade 1 group(CIN1),high grade CIN and SCC group(CIN2-3/SCC). To analyze the results with clinical characteristics of each group, medical history,type of cervical transformation zone under colposcopy and pathological results. Result:(1)There were 48 cases in the normal group (24.49%). 56 cases belonged to the HPVI(28.57%). In the CIN1 group,there were 52 cases(26.53%). Also,40 cases belonged to CIN2-3/SCC(20.41%). In the CIN2-3/SCC group,the occur rate was higher,such as contact bleeding/more sex/earlier sex/smoking/low-studied.(2)In patients with type ⅠTZ,18 cases were diagnosed CIN2-3/SCC(19.78%). In tape ⅡTZ,there were 15 patients diagnosed CIN2-3/SCC(23.08%). However,there were 7 cases were diagnosed CIN2-3/SCC(17.50%)in patients with typeⅢ. The proportion of CIN2-3/SCC was significantly different among patients with different types of TZ(P<0.05),with type Ⅱhighest. Conclusion:Personal therapy should be taken to the ASCUS. With high-risk factors,low-economic,colposcope examination is the best way. With the typeⅢof cervical TZ,HR-HPV should be the first way.
