Cervicography Combined With Repeat Papanicolaou Test as Triage for Low‐Grade Cytologic Abnormalities
Cervicography Combined With Repeat Papanicolaou Test as Triage for Low‐Grade Cytologic Abnormalities
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宫颈造影联合重复巴氏试验作为低度细胞学异常的分诊
DOI：
10.1016/s0029-7844(98)00199-9
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发表时间：
1998
影响因子：
7.2
通讯作者：
Craig Landwehr
中科院分区：
文献类型：
--
作者：
Carolyn Eskridge;W. Begneaud;Craig Landwehr
目的：确定联合重复巴氏试验和宫颈造影术在既往有不确定意义的非典型鳞状细胞（ASCUS）或Bethesda系统诊断的低度鳞状上皮内病变（LSIL）患者中识别高度鳞状病变的有效性。方法：所有在1994年7月1日至1995年12月31日期间到慈善医院妇科诊所就诊的患者，巴氏试验结果为ASCUS或LSIL，均接受了重复巴氏试验、宫颈造影，阴道镜检查，适当时阴道镜引导活检，以及宫颈内刮除术。排除妊娠患者和接受子宫切除术的患者。从异常巴氏试验到临床调查的平均和中位时间分别为61和58天（范围6-162天）。在这187例患者中，发现24例（13%）患有宫颈上皮内瘤变（CIN）II-III级。第二次巴氏试验可检出24个病灶中的11个（敏感性46%），而宫颈造影可检出24个病灶中的22个（敏感性92%）。巴氏试验和宫颈造影联合诊断ASCUS的敏感性为91%。141例患者进行了初始LSIL巴氏试验。在这141例患者中，发现37例（26%）患者患有CIN II-III。重复巴氏试验将检测到37个病变中的29个（敏感性78%），而宫颈造影将检测到37个病变中的33个（敏感性89%）。结论：宫颈造影是一种有效的检查宫颈病变的方法，对有ASCUS或LSIL史的CIN Ⅱ ~ Ⅲ病变有较好的诊断价值。
Objective: To determine the efficacy of combined repeat Papanicolaou test and cervicography for identification of high-grade squamous lesions among patients who previously have had atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) diagnosed by the Bethesda System.Methods: All patients who presented to a charity hospital gynecology clinic between July 1, 1994, and December 31, 1995, with a Papanicolaou test result of ASCUS or LSIL underwent repeat Papanicolaou test, cervicography, colposcopy with colposcopic-directed biopsy when appropriate, and an endocervical curettage. Pregnant patients and those who had undergone hysterectomy were excluded. The mean and median time from abnormal Papanicolaou test to clinical investigation was 61 and 58 days, respectively (range 6-162 days).Results: One hundred eighty-seven of the patients had an initial ASCUS Papanicolaou test. Of these 187, 24 (13%) were found to have cervical intraepithelial neoplasia (CIN) grades II-III. The second Papanicolaou test would have resulted in the detection of 11 of 24 lesions (sensitivity 46%), whereas the cervigram would have detected 22 of 24 (sensitivity 92%). The combined Papanicolaou test and cervigram sensitivity for ASCUS was 91%. One hundred forty-one of the patients had an initial LSIL Papanicolaou test. Of these 141, 37 (26%) patients were found to have CIN II-III. The repeat Papanicolaou test would have detected 29 of 37 lesions (sensitivity 78%), whereas the cervigram would have detected 33 of 37 (sensitivity 89%). The combined Papanicolaou test and cervigram sensitivity for LSIL was 97%.Conclusion: Cervicography is a helpful adjunctive technique for detection of CIN II-III lesions in patients with previous ASCUS or LSIL Papanicolaou tests.