阴道镜在绝经后妇女宫颈非典型鳞状细胞中的诊治体会  

Diagnosis and treatment experience of colposcopy in cervical atypical squamous cells in postmenopausal women

作　　者：关若丽[1] 王友方[1] 孔令华[1] 饶丽萍[1] 

机构地区：[1]中国医学科学院北京协和医院妇产科,北京100730

出　　处：《中国临床医生杂志》2013年第6期22-24,共3页Chinese Journal For Clinicians

摘　　要：目的探讨绝经后妇女出现宫颈非典型鳞状细胞的临床诊治体会。方法选择细胞学检查结果为ASCUS的绝经后妇女(包括持续2次以上)290例,进行阴道镜检查和活检。结果 CINⅡ～Ⅲ共14例占绝经后ASCUS的26.41%。低于对照组29.48%。用卡方检验对比绝经前后妇女从ASCUS中检出CINⅡ～Ⅲ的病例百分比,χ2=0.1470,P=0.7015,差异无显著性。绝经后妇女不满意阴道镜比例上升,对阴道镜下活检的组织学结果没有显著影响,Fisher精确检验,P=0.7756,差异无显著性。HR-HPV DNA的检测在绝经后的妇女中感染的机会依然很高,可作为分流ASCU和随访手段,但与CIN的级别关系不大。结论绝经后妇女从ASCUS中检出CINⅡ～Ⅲ比例略低绝经前妇女,尽管不满意阴道镜比例上升,但对病理结果影响不大。所以提高阴道镜的操作水平可以降低患者的漏诊率。Objective To investigate the diagnostic performance of colposcopy in postmenopausal women with atypical squamous cells of cervix （ASCUS）. Method Select the cytology results for ASCUS in postmenopausal women （ including the last 2 times ） Colposcopy with directed biopsy was performed. Result CIN2 and CIN3 accounted for 26.41% lower than the control group （χ2= 0. 1470,P = 0. 7015 ）. The postmenopausal women increases the operational difficulty in colposcopy performance. But no significant influence was observed for the punch biopsy and related pathological outcomes, Fisher exact test, P= 0. 7756. High prevalence of HPV infection can still be detected in postmenopausal women and we utilize HPV test result to category patients with ASCUS, which also emphasizes the role of HPV test in patients follow-up. Conclusion The rate of CIN 2 - 3 is lower in postmenopausal women than premenopausal women. Although there is operational difficulty in colposcopy performance it did impart the pathological results. We conclude that skilled performance determines the diagnostic value of colposcopy in postmenopausal women with ASCUS.

关 键 词：绝经后 宫颈非典型鳞状细胞 阴道镜 移行带 

分 类 号：R711.74[医药卫生—妇产科学]