宫颈细胞学中异常角化细胞的临床风险分析  

Clinical risk analysis of abnormal keratinocyte cells in cervical cytology

作　　者：林宁[1] 石慧[1] 王丽娟[1] 陈伟[1] 姜志欣[1] 吴玉璘[1] 潘丽[1] 

机构地区：[1]江苏省生殖健康检验中心江苏省计划生育科学技术研究所,江苏南京210036

出　　处：《中国妇幼保健》2014年第1期23-25,共3页Maternal and Child Health Care of China

基　　金：江苏省科技厅社会发展项目〔BE2011806;BE2011807;BS2007080〕

摘　　要：目的:探讨宫颈细胞学中以异常角化细胞为主要判读细胞的病例的临床风险。方法:对484例细胞学诊断为LSIL的涂片进行回顾性观察,分析其中以异常角化细胞为主要判读细胞的病例,并追踪组织病理学结果。结果:484例细胞学诊断为LSIL的病例中,以异常角化细胞变化为主的病例102例,组织病理结果为:炎症11例,CINI 27例、CINⅡ22例、≥CINⅢ42例,所占比例分别为:10.78%、26.47%、21.57%、41.18%;以其他异常细胞为主要判读细胞的病例382例,组织病理结果为:炎症68例、CINI180例、CINⅡ62例、≥CINⅢ72例,所占比例分别为:17.80%、47.12%、16.23%、18.85%。以异常角化细胞变化为主的病例中的CINⅡ、CINⅢ所占比例要高于以其他异常细胞为主要判读细胞的病例,其中CINⅢ两者相比差异有统计学意义(P<O.01)。405例组织病理结果为CIN的病例中,细胞学以异常角化细胞变化为主的病例所占比例各为CINI13.04%(27/207)、26.20%(22/84)、≥CINⅢ38.53%(42/112),明显呈上升趋势。结论:细胞学诊断为LSIL中,以异常角化细胞变化为主要判读细胞的病例的临床风险明显要高于以其他异常细胞为主要判读细胞的病例,细胞学诊断应加强对这类细胞的识别,而临床应加强对这类病例的管理和随访。Objective： To explore the clinical risk of abnormal keratinocyte as the main interpretation standards in cervical cytology. Methods： 484 Pap smears with the cytological diagnosis of LSIL were observed retrospectively, and the cases by abnormal keratinoeyte as the main interpretation standards were selected, and their histopathology results were tracked. Results： 102 cases were singled out and the histopathology results were： inflammation （10. 78%, 11/102）, CIN I （26.47%, 27/102）, CIN Ⅱ （21.57%, 22/102）, ≥ CIN m （41.18%, 42/102） . The other 382 cases without the abnormal keratinoeyte showed： inflammation （17. 80%, 68/382） , CIN I （47. 12%, 180/382）, CINH （16. 23%, 62/382）, ≥CIN $ （18.85%, 72/382） . The proportion of CIN Ⅱ and CIN Ⅲ in cases of abnormal keratinoeyte as the main interpretation standards were higher than those of any other abnormal cells as main interpretation standards, there was significant difference in the proportion of CINⅢ （P 〈 0. 01 ） . In the 405 cases of CIN, the histopathology results with abnormal keratinocyte showed a rising trend form CINI to CINm ： CINI 13.04% （27/207）, CINⅡ 26. 20% （22/84）, ≥CINllI 38.53% （42/112） . Conclusion： In the LSIL cases, the clinical risk with abnormal keratinocyte as the main interpretation standards is significantly higher than that of other abnormal cells. It should be strengthened by the identification of cytological diagnosis, clinical management and follow - up of such cases.

关 键 词：角化细胞 宫颈涂片 临床风险 

分 类 号：R737.33[医药卫生—肿瘤]