Rate of pathology from atypical glandular cell pap tests classified by the Bethesda 2001 nomenclature
Rate of pathology from atypical glandular cell pap tests classified by the Bethesda 2001 nomenclature
复制标题
DOI：
10.1097/01.aog.0000218705.87329.4a
复制
发表时间：
2006-06-01
影响因子：
7.2
通讯作者：
Modesitt, Susan C.
中科院分区：
文献类型：
--
作者：
DeSimone, Christopher P.;Day, Misty E.;Modesitt, Susan C.
目的：估计由2001年Bethesda系统分类的非典型腺细胞（AGC）巴氏试验导致重大病理学的风险，并评估医师专业之间AGC管理实践的潜在差异。方法：进行图表研究以评估2001- 2005年期间诊断的AGC巴氏试验的结果。结果：从84，748次巴氏试验中确定了131次AGC巴氏试验。AGC的发生率为0.15%。39例AGC巴氏试验（30%）从分析中排除，留下82例患者的92例AGC巴氏试验可供审查。82名女性中有31名（38%）有明显的病理学改变。17名妇女（21%）有浸润前疾病：宫颈上皮内瘤变2或3，原位腺癌和子宫内膜增生，而14名妇女（17%）有子宫内膜，子宫颈，卵巢和直肠的浸润性腺癌。40岁或以下的女性与40岁以上的女性在最终病理学方面存在显着差异（P =.002）。具体来说，他们更有可能患有浸润前疾病，而不太可能患有浸润性癌。推荐的AGC治疗方法包括阴道镜下活检或不活检、宫颈刮除术和子宫内膜活检。82名妇女中有63名（77%）接受了推荐指南的管理，当比较妇科医生和初级保健医生时，医生依从性有统计学显著差异（87%比50%，P
OBJECTIVE: To estimate the risk of significant pathology from atypical glandular cell (AGC) Pap tests classified by the 2001 Bethesda system and to assess potential differences in AGC management practices between physician specialties.METHODS: A chart study was conducted to assess outcomes from AGC Pap tests diagnosed during 2001-2005.RESULTS: One hundred thirty-one AGC Pap tests were identified from 84,748 Pap tests. The incidence of AGC was 0.15%. Thirty-nine AGC Pap tests (30%) were excluded from analysis, leaving 92 AGC Pap tests from 82 patients available for review. Thirty-one of 82 women (38%) had significant pathology. Seventeen women (21%) had preinvasive disease: cervical intraepithelial neoplasia 2 or 3, adenocarcinoma in situ and endometrial hyperplasia, whereas 14 women (17%) had invasive adenocarcinomas of the endometrium, cervix, ovary, and rectum. Women who were aged 40 years or younger differed significantly from women aged older than 40 years with regard to final pathology (P =.002). Specifically, they were more likely to have preinvasive disease and less likely to have invasive carcinoma. Recommended management for AGC includes colposcopy with or without biopsy, endocervical curettage, and endometrial biopsy. Sixty-three of 82 (77%) women were managed by recommended guidelines, and there was a statistically significant difference in physician adherence when comparing gynecologists to primary care physicians (87% compared with 50%, P