中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2009年
39期
2779-2782
,共4页
细胞学%AGC%阴道镜检查%宫颈上皮内瘤变%病理学
細胞學%AGC%陰道鏡檢查%宮頸上皮內瘤變%病理學
세포학%AGC%음도경검사%궁경상피내류변%병이학
Cytology%Atypical glandular cells%Colposcopy%Cervical intraepithelial neoplasia%Histopathology
目的 探讨宫颈细胞学结果中不典型腺上皮细胞(AGC)的组织病理学特点及临床意义.方法 选择87例宫颈细胞学AGC患者,分析其阴道镜检查,宫颈活检、分段诊刮、子宫颈电热圈环切术(LEEP)的病理及随访结果.结果 (1)87例中病理异常35例(40.23%):腺上皮病变10(11.49%)例,包括子宫内膜轻度非典型增生2例、宫颈腺上皮内瘤变3例、宫颈腺癌3例、子宫内膜腺癌2例;宫颈鳞状上皮内病变(CIN)25例(28.74%).(2)61例细胞学AGC不明意义(AGC NOS)有18例病理异常(29.51%);16例AGC提示倾向内瘤变(AGC SIL)中有9例组织学异常;10例为原位腺癌(A1S)/腺癌中,6例病理异常.病理异常在细胞学AGC NOS与AGC SIL或AIS比较差异有统计学意义,P<0.05.(3)除2例子宫内膜腺癌及3例宫颈腺癌行开腹手术外,余82例行随访,随访率100%.随访时间6～46个月.随访中3例再次出现细胞学异常,经病理证实1例CIN1、1例CIN2、1例CIN3.(4)10例病理腺上皮病变中,除1例CGIN1患者的年龄<35岁,余年龄均≥35岁.结论 AGC中40.23%的患者有组织学异常.因存在CIN及癌,应行阴道镜检查及组织学确诊.疾病的存在与年龄有关,年龄≥35岁的患者存在腺癌和子宫内膜癌的概率增加,因此应重视年龄35岁以上妇女宫颈细胞学AGC的结果.
目的 探討宮頸細胞學結果中不典型腺上皮細胞(AGC)的組織病理學特點及臨床意義.方法 選擇87例宮頸細胞學AGC患者,分析其陰道鏡檢查,宮頸活檢、分段診颳、子宮頸電熱圈環切術(LEEP)的病理及隨訪結果.結果 (1)87例中病理異常35例(40.23%):腺上皮病變10(11.49%)例,包括子宮內膜輕度非典型增生2例、宮頸腺上皮內瘤變3例、宮頸腺癌3例、子宮內膜腺癌2例;宮頸鱗狀上皮內病變(CIN)25例(28.74%).(2)61例細胞學AGC不明意義(AGC NOS)有18例病理異常(29.51%);16例AGC提示傾嚮內瘤變(AGC SIL)中有9例組織學異常;10例為原位腺癌(A1S)/腺癌中,6例病理異常.病理異常在細胞學AGC NOS與AGC SIL或AIS比較差異有統計學意義,P<0.05.(3)除2例子宮內膜腺癌及3例宮頸腺癌行開腹手術外,餘82例行隨訪,隨訪率100%.隨訪時間6～46箇月.隨訪中3例再次齣現細胞學異常,經病理證實1例CIN1、1例CIN2、1例CIN3.(4)10例病理腺上皮病變中,除1例CGIN1患者的年齡<35歲,餘年齡均≥35歲.結論 AGC中40.23%的患者有組織學異常.因存在CIN及癌,應行陰道鏡檢查及組織學確診.疾病的存在與年齡有關,年齡≥35歲的患者存在腺癌和子宮內膜癌的概率增加,因此應重視年齡35歲以上婦女宮頸細胞學AGC的結果.
목적 탐토궁경세포학결과중불전형선상피세포(AGC)적조직병이학특점급림상의의.방법 선택87례궁경세포학AGC환자,분석기음도경검사,궁경활검、분단진괄、자궁경전열권배절술(LEEP)적병리급수방결과.결과 (1)87례중병리이상35례(40.23%):선상피병변10(11.49%)례,포괄자궁내막경도비전형증생2례、궁경선상피내류변3례、궁경선암3례、자궁내막선암2례;궁경린상상피내병변(CIN)25례(28.74%).(2)61례세포학AGC불명의의(AGC NOS)유18례병리이상(29.51%);16례AGC제시경향내류변(AGC SIL)중유9례조직학이상;10례위원위선암(A1S)/선암중,6례병리이상.병리이상재세포학AGC NOS여AGC SIL혹AIS비교차이유통계학의의,P<0.05.(3)제2례자궁내막선암급3례궁경선암행개복수술외,여82례행수방,수방솔100%.수방시간6～46개월.수방중3례재차출현세포학이상,경병리증실1례CIN1、1례CIN2、1례CIN3.(4)10례병리선상피병변중,제1례CGIN1환자적년령<35세,여년령균≥35세.결론 AGC중40.23%적환자유조직학이상.인존재CIN급암,응행음도경검사급조직학학진.질병적존재여년령유관,년령≥35세적환자존재선암화자궁내막암적개솔증가,인차응중시년령35세이상부녀궁경세포학AGC적결과.
Objective To determine the pathological features and clinical implications of atypical glandular cells of undetermined significance (AGC) in cervical cytological results.Methods All 87 cases of cervical cytological examinations with AGC were identified by a computerized database in our patient population.The authors analyzed the cervical histopathological results by colposcopic biopsy,dilatation and curettage(D&C),cervical loop electrosurgical excision procedure (LEEP)and follow-ups.Results (1) Thirty-five cases (40.23%) had cervical and endometrial neoplasic findings:ten glandular lesions (11.49%) and squamous lesion was present in 25 patients (28.74%).(2) Among 61 patients with Pap smears subclassified as "AGC-not otherwise specified",there were 18 pathological abnormalities.Sixteen patients with AGC as "favor intraepithelial neoplasia" were of 9 pathological abnormalities.Ten patients with AGC as "adenocarcinoma in situ" or "adenocarcinoma" were of 6 pathological abnormalities.(3) 100% of patients with AGC had both of colposcopic and cytologic follow-ups:1 case CIN1,1 case CIN2 and 1 case CIN3.(4) One of 10 patients was younger than 35 years old with CGIN1 and the other 9 patient aged over 35 years old had a greater diversity of glandular lesions.Conclusion A finding of AGC requires both colposcopy and an aggressive workup because of a high rate of cancer and precancerous lesions.The onset of disease is age-related.Women aged over 35 years old has a greater diversity of glandular lesions and account for most cases of cervical and endometrial adenocarcinoma.
