Histopathologic correlation of atypical parakeratosis diagnosed on cervicovaginal cytology
Histopathologic correlation of atypical parakeratosis diagnosed on cervicovaginal cytology
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DOI：
10.1159/000326541
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发表时间：
2003-05-01
期刊：
影响因子：
1.8
通讯作者：
Abdul-Karim, FW
中科院分区：
文献类型：
--
作者：
Abramovich, CM;Wasman, JK;Abdul-Karim, FW
目的：回顾性研究的组织病理学发现的妇女与孤立的发现非典型角化不全（PK）的Pap test.Study设计：细胞学文件（1999-2001年）进行了搜索宫颈阴道Pap试验解释为非典型PK。只有在细胞学检查后1年内有后续宫颈阴道组织样本，并且在过去5年内没有鳞状上皮内病变（SIL）的诊断，病例才被纳入研究。结果：在355例非典型PK患者中，109例（年龄14-69岁，平均31.5岁）符合本研究的入选标准。细胞学检查和宫颈阴道组织检查之间的间隔时间为0.5至12个月（平均2.5个月）。61例患者同时接受宫颈刮除术（ECC）和宫颈活检（CBx），20例患者仅接受ECC，19例患者仅接受CBx，其余患者接受其他手术。组织样本的组织学结果包括：无显著病理变化，但无鳞状上皮可供评价（n = 10，9.2%），除角化过度和/或PK以外的良性变化（n = 50，45.9%）、角化过度和/或PK（n = 8，7.3%），低度SIL（n = 33，30.3%），高等级SIL（n = 6，5.5%）和浸润性鳞状细胞癌结论：在大约40%的患者中，巴氏试验中非典型PK的孤立发现与潜在SIL或浸润性癌的存在相关。其中，80%为低度SIL。非典型PK的细胞学结果需要进一步研究，以排除锡尔斯和/或癌。我们建议将非典型PK常规纳入意义不明的非典型鳞状细胞类别。
OBJECTIVE: To retrospectively examine the histopathologic findings in women with the isolated finding of atypical parakeratosis (PK) on a Pap test.STUDY DESIGN: The cytology files (1999-2001) were searched for cervico-vaginal Pap tests interpreted as atypical PK. Cases were included for study only if there was a subsequent cervicovaginal tissue sample within 1 year of the cytologic interpretation and there was no diagnosis of squamous intraepithelial lesion (SIL) within the previous five years.RESULTS: Of 355 patients with atypical PK, 109 (aged 14-69 years, mean 31.5) met the inclusion criteria of the study. The interval between the cytologic interpretation and cervicovaginal tissue examination ranged from 0.5 to 12 months (mean, 2.5). Sixty-one patients underwent both endocervical curettage (ECC) and cervical biopsy (CBx), 20 patients underwent ECC only, 19 patients underwent CBx only, and the remainder underwent other procedures. Histopathologic findings on the tissue samples included: no significant pathologic change but no squamous epithelium present for evaluation (n = 10, 9.2%), benign changes other than hyperkeratosis and/or PK (n = 50, 45.9%), hyperkeratosis and/or PK (n = 8, 7.3%), low grade SIL (n = 33, 30.3%), high grade SIL (n = 6, 5.5%) and invasive squamous cell carcinoma (n = 2, 1.8%).CONCLUSION: The isolated finding of atypical PK on a Pap test correlated with the presence of an underlying SIL or invasive carcinoma in approximately 40% of patients. Of these, 80% had low grade SIL. The cytologic finding of atypical PK warrants further investigation in order to exclude SILs and/or carcinoma. We suggest thatatypical PK be routinely included in the category of atypical squamous cells of undetermined significance.