2001 consensus guidelines for the management of women with cervical cytological abnormalities
2001 consensus guidelines for the management of women with cervical cytological abnormalities
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DOI：
10.1001/jama.287.16.2120
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发表时间：
2002-04-24
影响因子：
120.7
通讯作者：
Wilkinson, EJ
中科院分区：
文献类型：
--
作者：
Wright, TC;Cox, JT;Wilkinson, EJ
目的 为宫颈细胞学异常和宫颈癌前兆女性的管理提供循证共识指南。 参会人员 由 121 名宫颈癌前兆诊断和管理专家组成的小组，包括来自 29 个专业组织、联邦机构以及国家和国际卫生组织的代表，受邀参加由美国阴道镜和宫颈病理学会 (ASCCP) 主办的共识会议。 宫颈细胞学异常女性管理的证据和共识流程指南是通过多步骤过程开发的。从会议召开前 6 个月开始，工作组根据 1988 年至 2001 年发表的英文文章的正式文献综述以及通过交互式互联网公告板获得的广大专业团体的意见，制定了管理指南草案。 2001年9月6日至8日，ASCCP共识会议在马里兰州贝塞斯达举行。提出了带有支持证据的指南，并进行了讨论、修订和投票。 结论 对女性非典型鳞状细胞（ASC）的处理取决于巴氏试验是否被分类为意义未定（ASCUS）或不能排除高级鳞状上皮内病变（HSIL）（ASC-H）。患有 ASC-US 的女性应采用 2 次重复细胞学检测、立即阴道镜检查或高危类型人乳头瘤病毒 (HPV) DNA 检测的方案进行管理。当使用液基细胞学进行筛查时，HPV DNA 检测是首选方法。在大多数情况下，患有 ASC-H、低度鳞状上皮内病变、HSIL 和非典型腺细胞的女性应立即转诊进行阴道镜评估。
Objective To provide evidence-based consensus guidelines for the management of women with cervical cytological abnormalities and cervical cancer precursors.Participants A panel of 121 experts in the diagnosis and management of cervical cancer precursors, including representatives from 29 professional organizations, federal agencies, and national and international health organizations, were invited to participate in a consensus conference sponsored by the American Society for Colposcopy and Cervical Pathology (ASCCP).Evidence and Consensus Process Guidelines for the management of women with cervical cytological abnormalities were developed through a multistep process. Starting 6 months before the conference, working groups developed draft management guidelines based on formal literature reviews of English-language articles published in 1988-2001, as well as input from the professional community at large, obtained using interactive Internet-based bulletin boards. On September 6-8, 2001, the ASCCP Consensus Conference was held in Bethesda, Md. Guidelines with supporting evidence were presented and underwent discussion, revision, and voting.Conclusions Management of women with atypical squamous cells (ASC) depends on whether the Papanicolaou test is subcategorized as of undetermined significance (ASCUS) or as cannot exclude high-grade squamous intraepithelial lesion (HSIL) (ASC-H). Women with ASC-US should be managed using a program of 2 repeat cytology tests, immediate colposcopy, or DNA testing for high-risk types of human papillomavirus (HPV). Testing for HPV DNA is the preferred approach when liquid-based cytology is used for screening. In most instances, women with ASC-H, low-grade squamous intraepithelial lesion, HSIL, and atypical glandular cells should be referred for immediate colposcopic evaluation.