非典型腺细胞在宫颈细胞学筛查中的应用价值  

Clinical Diagnostic Value of Atypical Glandular Cells

作　　者：陈平[1] 胡正强[1] 岳新爱[1] 唐袁婷[1] 吴秀丽[1] 江咏梅[1] 

机构地区：[1]四川大学华西第二医院临床检验科,四川成都610041

出　　处：《现代临床医学》2016年第4期253-255,共3页Journal of Modern Clinical Medicine

基　　金：四川省科技厅科技支撑计划项目(2013SZ0037)

摘　　要：目的：通过分析宫颈细胞学筛查试验中非典型腺细胞（AGC）病例的组织学结果,讨论AGC诊断的临床应用价值及管理方法。方法：对我院2015年1—6月宫颈细胞学筛查试验中报告为AGC的病例中实施宫颈多点活组织检查、子宫颈电热圈环切术（loop electrosurgical excision procedure,LEEP）、宫颈锥切、宫颈搔刮、分段诊刮、子宫全切术后等组织学结果进行统计分析。结果：我院2015年1—6月宫颈细胞学筛查试验中诊断为AGC病例共108例,92例有组织学检查结果,16例失访。以组织学检查结果报告为上皮非典型增生及以上病变作为阳性结果进行归纳分类。35例组织学检查结果阴性,其中慢性宫颈炎17例,子宫内膜炎4例,宫颈息肉5例,子宫内膜息肉3例,子宫内膜增生6例。57例组织学检查结果阳性,其中宫颈上皮内瘤样变（cervical intraepithelial neoplasia,CIN）12例（CINⅠ4例,CINⅡ~Ⅲ8例且3例累及腺体）,宫颈鳞状细胞癌1例,宫颈腺上皮内瘤样病变（cervical glandular intraepithelial neoplasia,CGIN）7例,子宫内膜癌17例,宫颈腺癌13例,卵巢腺癌5例和输卵管腺癌2例。结论：AGC与多种癌及癌前病变密切相关,有重要的临床诊断价值。提示对于宫颈细胞学筛查报告为AGC的患者进行定期追踪随访和规范的临床诊疗是非常必要的。Objective： To analyze histological results of atypical glandular cell（ AGC） diagnosed by cervical cytology screening,and to discuss the clinical diagnostic value of AGC. Methods： AGC cases diagnosed by cervical cytology screening between January 2015 and June 2015 in our hospital received cervical multiple punch biopsy,cervical loop electrosurgical excision procedure（ LEEP）,cervical conization,cervical scoraping,fractional curettage and total hysterectomy,etc.. The results were analyzed statistically. Results： A total of 108 cases were diagnosed as AGC by cervical cytology screening. Of them,92 cases had histological results,and 16 cases failed to follow-up. Histological results were considered to be positive for epithelial atypical hyperplasia and above lesions. 35 cases were negative including 17 of chronic cervicitis,4 of endometritis,5 of cervical polyp,3 of endometrial polyp,6 of endometrial hyperplasia. 57 cases were positive including 12 of cervical intraepithelial neoplasia（ CIN,4 of CIN Ⅰ,8 of CIN Ⅱ-Ⅲ,and 3 of gland involvement）,17 of endometrial carcinoma,13 of cervical adenocarcinoma,5 of ovarian adenocarcinoma and 2 of fallopian tube adenocarcinoma. Conclusion： AGC is of important diagnostic value due to the close relation to varied cancers and precancerous lesions. It is very necessary to carry out regular follow-up and standardized clinical treatment in AGC patients diagnosed by cervical cytology screening.

关 键 词：非典型腺细胞 宫颈腺上皮内瘤样变 腺癌 子宫颈电热圈环切术 

分 类 号：R446.1[医药卫生—诊断学] R737.3[医药卫生—临床医学]