Transformation zone location and intraepithelial neoplasia of the cervix uteri
Transformation zone location and intraepithelial neoplasia of the cervix uteri
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DOI：
10.1038/bjc.1996.388
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发表时间：
1996-08-01
影响因子：
8.8
通讯作者：
Grivegnee, AR
中科院分区：
文献类型：
--
作者：
Autier, P;Coibion, M;Grivegnee, AR
我们通过宫颈造影检查评估了 8758 名女性的宫颈癌前病变频率与宫颈变性区位置之间的关系。同时进行宫颈内和宫颈外涂片检查。召回涂片检查分类为 CIN I 或以上的女性，并在阴道镜下对任何异常区域进行活检。 25岁以下女性中，94%的变性区位于外宫颈；随着年龄的增长，变性区位于外宫颈的女性比例逐渐下降，64岁后降至不足2%。与在子宫颈管内有转化区的女性相比，在外宫颈管内转化区的女性中，发现经组织学证实的发育不良病变的年龄调整可能性高出 1.8 倍（95% 置信区间 1.1-2.9）。这种较高的频率似乎并不是由于当转化区被隐藏时涂片测试的灵敏度较低。结果还表明，分娩倾向于显着地维持外宫颈上的转化区。经产是宫颈癌的已知危险因素，但其促进恶性病变的机制仍不清楚。我们的结果表明，随着活产数量的增加，转化区直接暴露于涉及发育不良病变的外部因素的时间更长。
We examined the relationship between the frequency of premalignant lesions of the cervix and location of the transformation zone on the cervix among 8758 women as assessed using cervicography. An endo- and exocervical smear test was performed at the same time. Women with smear test classified CIN I or more were recalled and any abnormal area was biopsied under colposcopy. The transformation zone was located on the exocervix in 94% of women younger than 25 years old; as age increased, the proportion of women with a transformation zone located on the exocervix steadily decreased to reach less than 2% after 64 years old. As compared with women having a transformation zone in the endocervical canal, the age-adjusted likelihood of discovering a histologically proven dysplastic lesion was 1.8 times more frequent among women with a transformation zone located on the exocervix (95% confidence interval 1.1-2.9). This higher frequency seemed not attributable to a lower sensitivity of the smear test when the transformation zone was hidden, The results also showed that deliveries tended significantly to maintain the transformation zone on the exocervix. Parity is a known risk factor for cervix cancer, but the mechanism by which it favours malignant lesions remains unknown. Our results suggest that with increasing numbers of livebirths, the transformation zone is directly exposed for longer periods to external agents involved in dysplastic lesions.