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目的:探讨电子阴道镜检查及宫颈活体组织病理学检查在宫颈细胞学意义不明确的非典型鳞状细胞(ASCUS)的进一步诊断中的应用价值。方法:对2007年1月～2009年7月在长春市中心医院妇产科门诊常规行宫颈液基细胞学(LPT)检查,筛查出ASCUS病例210例,全部行电子阴道镜检查,提示其中125例为正常或宫颈炎症;观察或对症治疗3个月后,复查宫颈液基细胞学(LPT),其中2例仍为ASCUS,阴道镜下取活检送病理,余病例均转为正常。另85例于电子阴道镜下诊断为宫颈上皮内瘤变,后镜下取宫颈活检行病理检查。结果:210例ASCUS患者,宫颈活检87例,最终确诊宫颈上皮内瘤变者68例,其中CINⅠ32例,CINⅡ30例,CINⅢ5例,宫颈原位癌1例。余患者均为正常宫颈或宫颈炎症,对症治疗3个月后复查LPT均正常,随访6～12个月复查宫颈细胞学检查未见异常。结论:宫颈细胞学ASCUS患者多数为正常或宫颈炎症改变(142/210),可先行阴道镜筛查,必要者镜下取宫颈活检送病理,既可降低不必要的宫颈损伤,又能提高诊断率,避免漏诊。
Objective: To investigate the value of electronic colposcopy and cervical biopsy in the further diagnosis of atypical squamous cell (ASCUS) with undefined cervical cytology. Methods: From January 2007 to July 2009 in Changchun Central Hospital Obstetrics and Gynecology clinic routine cervical liquid-based cytology (LPT) examination, screened 210 cases of ASCUS cases, all performed by electronic colposcopy, suggesting that 125 cases were normal or cervical inflammation. After 3 months of observation or symptomatic treatment, cervical liquid-based cytology (LPT) was reviewed. Two cases were still ASCUS. Colposcopic biopsy and pathological examination were performed. All cases were normal. The other 85 cases were diagnosed as cervical intraepithelial neoplasia by electronic colposcopy, and underwent cervical biopsy under the microscope. Results: A total of 210 cases of ASCUS, 87 cases of cervical biopsy and 68 cases of final diagnosis of cervical intraepithelial neoplasia were included. There were 32 cases of CINⅠ, 30 cases of CINⅡ, 5 cases of CINⅢ and 1 case of cervical carcinoma in situ. The remaining patients were normal cervical or cervical inflammation, symptomatic treatment of 3 months after the review of LPT were normal, follow-up of 6 to 12 months of cervical cytology examination showed no abnormalities. CONCLUSIONS: Cervical cytology ASCUS patients with most of the normal or cervical inflammation (142/210), colposcopy screening can be carried out before the need for microscopic cervical biopsy to send the pathology, both to reduce unnecessary cervical injury, but also improve the diagnosis Rate, to avoid missed diagnosis.