The Bethesda classification for squamous intraepithelial lesions: histologic, cytologic, and viral correlates.
The Bethesda classification for squamous intraepithelial lesions: histologic, cytologic, and viral correlates.
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鳞状上皮内病变的贝塞斯达分类：组织学、细胞学和病毒相关性。
DOI：
10.1097/00006250-199203000-00003
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发表时间：
1992
影响因子：
7.2
通讯作者：
Crum,CP
中科院分区：
文献类型：
--
作者：
Tabbara,S;Saleh,AD;Andersen,WA;Barber,SR;Taylor,PT;Crum,CP
在将Bethesda分类系统应用于宫颈鳞状病变时，我们评估了76名临床患者的巴氏涂片、宫颈活检和人乳头状瘤病毒(HPV)DNA状况。活检标本和并发的巴氏涂片按照低度和高度鳞状上皮内病变的标准进行分析，活检组织进行HPVDNA的原位杂交分析。两个独立的观察者在细胞学(kappa=0.62)和组织学(kappa=0.71)诊断上都有很好的一致性。高级别细胞学(对于高级别组织学)的预测值很高(评价者1的预测值为0.95；评价者2的预测值为0.97)，并且高级别细胞学和组织学都与某些高危HPV类型密切相关。相反，低度细胞学对低度组织学或高危以外的HPV类型的预测价值很低。这项研究支持使用某些组织学标准将鳞状上皮内病变区分为两个级别。细胞学-组织学相关性的局限性似乎反映了缺乏细胞学标准来区分与高危HPV类型相关的分化良好的前驱病变(Obstet Gyneol 1992；79：338-46)。
In applying the Bethesda System of classification to cervical squamous lesions, we evaluated the Papanicolaou smears, cervical biopsies, and human papillomavirus (HPV) DNA status of 76 clinic patients. The biopsy specimens and concurrent Papanicolaou smears were analyzed using criteria for low-grade and high-grade squamous intraepithelial lesions, and the biopsies were analyzed for HPV DNA by in situ hybridization. Two independent observers produced good agreement in both cytologic (kappa= 0.62) and histologic (kappa= 0.71) diagnoses. Predictive values of highgrade cytology (for high-grade histology) were high (0.95 for reviewer 1; 0.97 for reviewer 2), and both high-grade cytology and histology correlated strongly with certain “highrisk” HPV types. In contrast, the predictive value of lowgrade cytology for either low-grade histology or HPV types other than “high risk” was poor. This study supports the use of certain histologic criteria for distinguishing squamous intraepithelial lesions into two grades. Limitations in cytologic-histologic correlation appear to reflect the absence of cytologic criteria for distinguishing well-differentiated precursor lesions associated with high-risk HPV types.(Obstet Gynecol 1992; 79: 338-46)