CIN 2/3 and Cervical Cancer After an ASCUS Pap Smear
CIN 2/3 and Cervical Cancer After an ASCUS Pap Smear
复制标题
ASCUS 子宫颈抹片检查后的 CIN 2/3 和宫颈癌
DOI：
10.1159/000326673
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发表时间：
2003
期刊：
影响因子：
1.8
通讯作者：
S. Thoresen
中科院分区：
文献类型：
--
作者：
J. Nygård;T. Sauer;F. Skjeldestad;Gry Baadstr;S. Nil;S. Thoresen
目的
根据诊断意义不明的非典型鳞状细胞（ASCUS）后进行的诊断和筛查程序，估计诊断为宫颈上皮内瘤样病变（CIN）2/3或浸润性宫颈癌（ICC）的风险，并将该风险与巴氏涂片正常的女性进行比较。
研究设计
在挪威基于人群的协调筛查项目中进行了一项为期7年的前瞻性队列研究。在排除了随访中的异常巴氏涂片或有CIN 2/3或ICC病史的妇女后，研究人群包括1995-1996年25-69岁的正常（n = 526，661）或ASCUS巴氏涂片（n = 10，037）的妇女。通过logistic和参数生存回归计算风险估计值。
结果
在ASCUS涂片的7年内，1，017名妇女（10.1%）被诊断为CIN 2/3，62名（0.62%）被诊断为ICC。在随访的前2年内，与正常指数涂片的妇女相比，ASCUS指数巴氏涂片的妇女被诊断为组织学证实的CIN 2/3或ICC的相对风险为15-30。在长期随访中，ASCUS指数涂片正常的女性，取消了进一步的临床随访，与指数涂片正常的女性相比，CIN 2/3和浸润性癌症的风险高出> 3.5倍。
结论
对ASCUS涂片妇女进行巴氏涂片随访并不能确定所有CIN 2/3和ICC风险较高的妇女。应实施其他诊断程序以改善筛查计划。
OBJECTIVE
To estimate the risk of being diagnosed with cervical intraepithelial neoplasia (CIN) 2/3 or invasive cervical cancer (ICC) based on diagnostic and screening procedures performed after a diagnosis of atypical squamous cells of undetermined significance (ASCUS) and to compare this risk to that in women with a normal Pap smears.
STUDY DESIGN
A 7-year, prospective, cohort study was performed in the Norwegian population-based, coordinated screening program. After excluding women in the midst of follow-up of an abnormal Pap smear or with a history of CIN 2/3 or ICC, the study population consisted of women 25-69 years of age with a normal (n = 526,661) or ASCUS Pap smear (n = 10,037) in 1995-1996. Risk estimates were calculated by logistic and parametric survival regression.
RESULTS
Within 7 years of an ASCUS smear, 1,017 women (10.1%) were diagnosed with CIN 2/3 and 62 (0.62%) with ICC. Women with an ASCUS index Pap smear had a relative risk of 15-30 of being diagnosed with histologically verified CIN 2/3 or ICC within the first 2 years of follow-up as compared to women with a normal index smear. In long-term follow-up, women with an ASCUS index smear followed by a normal smear, which cancelled further clinical follow-up, were at > 3.5 times higher risk of both CIN 2/3 and invasive cancer as compared to women with a normal index smear.
CONCLUSION
Pap smear follow-up of women with an ASCUS smear does not identify all women at higher risk of CIN 2/3 and ICC. Other diagnostic procedures should be implemented to improve the screening program.