不能明确意义的非典型鳞状上皮细胞形态学进一步分类及临床意义  

Further morphological classification and clinical significance of atypical squamous cells of undetermined significance

作　　者：梅平[1] 李旻[1] 邝丽娟[1] 罗东兰[1] 王小冰[1] 徐方平[1] 张明辉[1] 林华欢[1] 庄恒国[1] 刘艳辉[1] 

机构地区：[1]广东省医学科学院广东省人民医院病理科,广州510080

出　　处：《临床与实验病理学杂志》2012年第11期1239-1242,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：广东省自然科学基金自由申请项目(8151008004000022)

摘　　要：目的对不能明确意义的非典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASCUS)的形态学进一步分类,探讨其临床意义。方法分析1 153例ASCUS,依据形态学分为少许异型鳞状上皮细胞组(ASCUSⅠ组)、倾向于低度鳞状上皮内病变组(low grade squamous intraepithelial lesion,LSIL)(ASCUSⅡ组)、不除外鳞状上皮内病变组(ASCUSⅢ组)及未能进一步分类组(ASCUSⅣ组);对其中662例进行随访。结果 ASCUSⅠ组中阴性62.12%(205/330)、ASCUS5.45%(18/330)、LSIL 28.48%(94/330)、高度鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)3.94%(13/330);ASCUSⅡ组中阴性45.45%(50/110)、ASCUS 2.73%(3/110)、LSIL 49.09%(54/110)、HSIL 2.73%(3/110);ASCUSⅢ组中阴性48.24%(14/29)、ASCUS 3.45%(1/29)、LSIL 24.14%(7/29)、HSIL 17.24%(5/29)、鳞状细胞癌6.90%(2/29);AS-CUSⅣ组中阴性45.08%(87/193)、ASCUS 3.62%(7/193)、LSIL 46.11%(89/193)、HSIL 5.18%(10/193)。经统计学分析,ASCUSⅠ组的阴性率明显高于其他组(P<0.05);ASCUSⅢ组的HSIL检出率明显高于其他组(P<0.01);ASCUSⅡ组及AS-CUSⅣ组的LSIL检出率明显高于ASCUSⅠ组及ASCUSⅢ组。结论 ASCUS的形态学进一步分类有一定的临床意义,具有指导价值。Purpose To reclassify atypical squamous cells of undetermined significance （ASCUS） morphologically and to investigate its significance. Methods 1 153 women with ASCUS smear were reclassified to four groups morphologically： a few atypia squamous cells group （ ASCUS I group）, favor low grade squamous intraepithehal lesion （ LSIL, ASCUS II group）, ASCUS cannot exclude squamous intraepithelial lesion （ASCUS m group） and ASCUS not otherwise specified （ASCUS IV group）. 662 women with ASCUS smear were followed up. Results In ASCUS I group, negative, ASCUS, LSIL and HSIL were 62. 12% （205/330） , 5.45 % （ 18/ 330）, 28.48% （94/330） and 3.94% （13/330） respectively. In ASCUS Ⅱ group, negative, ASCUS, LSIL and HSIL were 45.45% （50/110）, 2. 73% （3/110）, 49.09% （54/110） and 2. 73% （3/110） respectively. In ASCUS m group, negative, ASCUS, LSIL, HSIL and squamous carcinoma cell were 48.24% （ 14/29）, 3.45% （ 1/29）, 24. 14% （7/29）, 17.24% （5/29） and 6. 90% （2/ 29） respectively. In ASCUS IVgroup, negative, ASCUS, LSIL and HSIL were 45.08% （87/193）, 3.62% （7/193）, 46. 11% （89/ 193） and 5. 18% （10/193） respectively. Negative rate in ASCUS I group was higher than that in the other groups （P 〈0. 05）. HSIL rate in ASCUS l]Igroup was higher than that in the other groups （ P 〈0. 01 ）. LSIL rates in ASCUS II and ASCUS 1Vgroup were higher than those in ASCUS I and ASCUS III group（P 〈 0. 05）. Conclusions Reclassification of atypical squamous cells of undetermined significance morphologically may be important significance and may be as a guide to clinical management.

关 键 词：鳞状上皮内病变 非典型鳞状上皮细胞 形态学 

分 类 号：R446.8[医药卫生—诊断学]