Résumé
Objective:To explore the clinical significance of colposcopy in cervical atypical squamous cell of undetermined significance(ASCUS).Methods: Total of 516 women in our department were diagnosed with ASCUS by cytological test(TCT), they were further colposcope test. 209 cases of cervical intraepithelial neoplassia(CIN)were biopsied under the colposcope. In 307 cases of chronic cervicitis were given conservative therapy for 1-3 treatment cycles. Twelve cases of second TCT examination abnormal were biopsied under the colposcope. 295 cases of those with negative cytology checks take TCT regularly.Results: Of the 516 cases, 221 cases of cervical were biopsy (42.82%). Among them, 30 cases were chronic cervicitis , 185 cases were cervical intraepithelial neoplasia (CIN I-III), 6 case were squamous cell carcinoma, respectively. 295 cases without cervical biopsy, the follow-up of 6-18 months TCT found no abnormality.Conclusion: For the patients with cervical ASCUS, colposcopy associate with pathology biopsy may be helpful for the diagnosis and can provide a reasonable and effective treatment scheme for patients.
Résumé
Objective To discuss the significance of high-risk human papilloma virus ( HR-HPV) detection by hybrid capture 2 (Hc-2) in managing the women with atypical squamous cell of undetermined significance (ASCIIS) and low grade squamous intraepithelial lesion (LSIL) of thin prep liquid-based cytology (TCT). Methods One hundred and seventy-eight women with ASCUS and 108 women with LSIL were studied. The infection of HR-HPV in the women was analyzed. And sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were used to evaluate the significance of HR-HPV detection by Hc-2 in managing the women with ASCUS and LSIL of TCT. Results Sensitivity,specificity, PPV and NPV of HR-HPV DNA detection by Hc-2 in screening CIN II or above in ASCUS were 89.83% (53/59),53.78% (64/119), 49.07% (53/108), 91.43% (64/70) respectively,and in LSIL were 97.62%(41/42),22.73%(15/66), 44.57%(41/92), 93.75%( 15/16) respectively. Conclusion HR-HPV detection by Hc-2 is an effective measure in managing the women with ASCUS and LSIL of TCT.
Résumé
OBJECTIVE: To evaluate qualification and determine the usefulness of human papillomavirus(HPV) DNA testing in women with cytologic smears read as atypical squamous cell of undetermined significance (ASCUS). METHOD: The study was based on 88 women with cytologic smears reported of ASCUS favoring either a reactive process or squamous intraepithelial lesion (SIL) from July 1999 to June 2000. Cytologic examination by Papanicolaou smear was based on the Bethesda System and cervical biopsy was done via coloscopy. the presence of high risk HPV DNA was determined with Hybrid capture assay. RESULTS: The overall incidence of cervical intraepithelial lesion (CIN) was higher in the group with ASCUS favoring SIL than in the group with ASCUS favoring reactive process(42.2 % vs 18.6 %; p<0.05). Women with ASCUS favoring SIL were 9.1 times more likely to have high grade SIL(CIN II/III) develop than were women group with ASCUS favoring reactive process(95% confidence interval, 1.08-76.0). High-risk HPV DNA was demonstrated in 39.8%(35 cases) and was associated a 8.8 times increased likelihood of histologic conformation of CIN(95% confidence interval, 3.09-24.7). The sensitivity of HPV assay for any CIN was 74% and specificity was 75%, whereas the corresponding values for the repeat Pap smear was 67% and 33%, respectively. CONCLUSION: Women with ASCUS favoring SIL was associated with a relatively high risk that the women was harboring SIL. The addiction of a high-risk HPV DNA assay to cytologic examination appears to provide for early detection of high grade CIN in women with ASCUS.