Cervical cytology of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H): histological results and recurrence after a loop electrosurgical excision procedure
Cervical cytology of atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H): histological results and recurrence after a loop electrosurgical excision procedure
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DOI：
10.1007/s00404-010-1731-7
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发表时间：
2011-10-01
影响因子：
2.6
通讯作者：
Consolaro, M. E. L.
中科院分区：
文献类型：
--
作者：
Nogara, P. R. B.;Manfroni, L. A. R.;Consolaro, M. E. L.
目的评估ASC-H患者的环形电切除术（LEEP）手术组织的组织学和术后LEEP recurrence.Methods 2004年1月至2008年3月在巴拉那州Unio da Vitria镇接受LEEP治疗的ASC-H患者的病历，巴拉那州第六公共卫生区（CISVALI）的所在地进行了评估。结果ASC-H患者年龄多在40岁以下（71.1%），以20-39岁年龄组最多（P < 0.0001）。28例患者（73.3%）显示组织学病变。宫颈上皮内瘤样病变（CIN）Ⅰ 7例（18.4%），CIN Ⅱ和CIN Ⅲ各9例（23.7%），微小浸润性鳞状细胞癌（SCMCA）2例（5.3%），SCMCA+原位腺癌1例（2.2%）。在32例患者（84.2%）中，无切缘受累，包括100%的无异型增生组织学和CIN I，80.0%的CIN II和88.9%的CIN III。2例患者（5.3%）宫颈内受累，均为CIN II。4例患者（10.5%）有宫颈外和宫颈内受累，其中1例为CIN III，3例为癌。所有随访（+）的患者均为ASC-US，无异型增生或CIN I患者。结论ASC-H患者中很大一部分在LEEP术后组织学检查中有病变，主要是CIN II和III。这些数据显示了在阴道镜检查后立即通过LEEP治疗ASC-H的益处，但没有任何先前的组织学。
Objectives To evaluate the histology of the loop electrosurgical excision procedure (LEEP) surgical tissues of patients with ASC-H and post-LEEP recurrence.Methods Medical records of patients with ASC-H treated with LEEP between January 2004 and March 2008 in the town of Unio da Vitria, Parana, seat of the Sixth Public Health Region of Parana (CISVALI), were evaluated. The LEEP was carried out solely for ASC-H immediately after colposcopy, but without a histological diagnosis.Results Most patients were less than 40 years old (71.1%), with the largest group 20-39 years old (p < 0.0001). Twenty-eight patients (73.3%) showed histological lesions. Cervical intraepithelial neoplasias (CIN) I was present in 7 (18.4%), CIN II and CIN III in 9 (23.7%) each, microinvasive squamous cell carcinoma (SCMCA) in 2 (5.3%), and SCMCA plus in situ adenocarcinoma in 1 (2.2%). In 32 patients (84.2%), there was no involvement of the margins, including 100% with no dysplasia histology and CIN I, 80.0% of those with CIN II, and 88.9% of those with CIN III. Two patients (5.3%) had endocervical involvement, all of them with CIN II. Four patients (10.5%) had ectocervical and endocervical involvement, one of them with CIN III, and three of them with carcinomas. All patients with follow-up (+) were ASC-US, with no patients with dysplasia or CIN I.Conclusions A very high portion of the women with ASC-H had lesions on post-LEEP histological examination, principally CIN II and III. These data show the benefits of treatment for ASC-H by LEEP immediately after colposcopy but without any previous histology.