Cytological characteristics of premalignant cervical epithelial lesions in postmenopausal women based on endocrine indices and parakeratosis
Cytological characteristics of premalignant cervical epithelial lesions in postmenopausal women based on endocrine indices and parakeratosis
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DOI：
10.1097/gme.0000000000002125
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发表时间：
2023-02-01
期刊：
影响因子：
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通讯作者：
Kinjo, Takao
中科院分区：
文献类型：
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作者：
Sugisawa, Akiyuki;Toyoda, Zensei;Kinjo, Takao
目的通过内分泌指标和角化不全（PK）的存在，对绝经后妇女宫颈阴道涂片样本进行分析和比较，以确定检测癌前病变的细胞学结果。方法回顾性分析2012 ~ 2014年绝经后有癌前病变的妇女（n = 94）和无癌前病变的妇女（n = 344）的宫颈阴道涂片样本。细胞学诊断为恶性肿瘤或怀疑为恶性肿瘤的妇女被排除在本研究之外。比较各组间成熟指数（MI）、嗜酸性粒细胞指数（EI）及PK患病率等细胞学内分泌指标，采用2 × 2 chi(2)检验进行分析。还评估了内分泌指标与PK的存在和组织学结果的关系。结果绝经后有癌前病变的妇女内分泌指数（EI = 11%； 65%比43%，P < 0.01, f = 0.18）和PK阳性患病率（PK >= 1, 46%比7%，P < 0.01, f = 0.44）均高于无病变的妇女。进一步的分析表明，在有细胞学癌前病变的绝经后妇女中，高EI和PK的存在与组织学上的鳞状上皮内病变（SIL）高度相关（有癌前病变的妇女中有86%比没有癌前病变的妇女中有53%，P = 0.01, f = 0.34）。结论绝经后妇女高EI和高PK阳性与SIL相关。这些细胞学结果可能为检测异常增生提供潜在的诊断线索。
ObjectiveTo identify useful cytological findings for detecting premalignant lesions in postmenopausal women, cervicovaginal smear samples were analyzed and compared between women with or without premalignant lesions based on endocrine indices and presence of parakeratosis (PK).MethodsThe cervicovaginal smear samples of postmenopausal women with premalignant lesions (n = 94) and those who were without (n = 344), who were diagnosed between 2012 and 2014 were retrieved and analyzed. Women cytologically diagnosed with malignancy or those with suspicion of malignancy were excluded from this study. Cytological endocrine indices, such as the maturation index (MI) and eosinophilic index (EI) and the prevalence of PK were compared between the groups and analyzed using the 2 x 2 chi(2) test. The association of endocrine indices combined with the presence of PK and histological findings was also evaluated.ResultsPostmenopausal women with premalignant lesions had higher endocrine indices (EI of >= 11%; 65% vs. 43%, P < 0.01, f = 0.18) and a higher prevalence of PK positivity (PK >= 1; 46% vs. 7%, P < 0.01, f = 0.44) than those without lesions. Further analysis indicated that the combination of high EI and the presence of PK in postmenopausal women with cytological premalignant cases was highly associated with histological squamous intraepithelial lesions (SIL) (86% in women with premalignant lesions vs. 53% in those without; P = 0.01, f = 0.34).ConclusionOur research demonstrated that high EI and PK positivity were correlated with SIL in postmenopausal women. These cytological findings could provide potential diagnostic clues for detecting dysplasia.