| Background:cervical cancer is the most common form of gynecological malignancy, the incidence rate second only to breast cancer. Cervical cytologyscreening for cervical cancer and precancerous lesions is the most important way, the most common form of abnormal cervical cytology is ASC-US (atypical squamous cells of undetermined significance, undetermined significance atypical squamous cells).Clinicians on the treatment of ASC-US differences over how to effectively deal withASC-US became the focus of academic discussion, in which cases of cervical biopsyhas an important role in guiding diagnosis.Objectives:analysis of histopathology results and the significant of ACS-US diagnosed by cervical cytology.Methods:information of 247 patients of ACS-US diagnosed by cervical cytology was indentified from 1681 patients collected in the gynecology and obstetric(GO) clinic in Qilu Hospital of Shandong University. All of them got examinations of coloscope and colposcopically directed biopsy, and were classified by their pathology results. Calculated the proportions of chronic cervicitis, CINI, CINⅡ, CINⅢ, and invasive cervical carcinoma respectively, and made following analysis of these results:age distribution of ACS-US patients diagnosed by cervical cytology, post disposal and prognosis of these patients by telephone follow-up, conformity rate of the results between coloscope and pathology to check the significance of coloscope treatment of cervical diseases.Results:Age distribution:patients'age was from 22 to 72, and the average age was 40.6 years. Clinical syndromes of these included patients were mainly persistent leucorrhea, cervical erosion(I--III), postcoital bleeding,and vaginal bleeding without any reason, and a part of these patients did physical examination with no symptom. For the ACS-US patients of different cervical appearance, there was no statistic signifance among rates of inflammation,CIN and cervical carcinoma (x 2=3.72, p>0.05). The 247 ACS-US patients all accepted examinations of coloscope and biopsy, diagnosis of 129 patients was the same with that of pathology, and the conformity rate of the two methods was 52.22%. There were 52 more severe than CINI diagnosed by coloscope, with 22 by pathology, and the conformity rate was 42.31%. For the 247 ACS-US patients, there were 114 patients with cervicitis(46.15%),76 with CIN 1(30.77%),28 with CINⅡ(11.34%),26 with CIN 111(10.53%),3 with invasive cervical carcinoma(1.21%). Follow-up results:there were 100 followed-up by telephone out of 114 patients with pathology result of chronic cervicitis, in which 83 adopted drug therapy, like oral administration of antibiotics and antibiotics placed in vagina, and 17 without any treatment; there were 76 patients of CIN I with telephone follow-up by telephone,39 of them didn't get treatment, and for the left who got LEEP in our clinic,35 were with rutine postoperation pathology of 11 cervicitis,20 with CIN I,5 with CIN II,1 with CINIII; All the 28 patients with the pathology result of CIN II were followed-up by telephone, 3 of them didn't get treatment, and for the left who got LEEP in our clinic,25 were with rutine postoperation pathology of 1 cervicitis,3 with CIN I,20 with CIN II,1 with CINIII; for the 26 CINIII with telephone follow-up,19 got LEEP in the clinic,7 accepted conization of cervix, and the rutine postoperation pathology showed 26 were with rutine postoperation pathology of 2 cervicitis,2 with CIN I,5 with CIN II,17 with CIN III.3 cases of pathological results for squamous cell carcinoma of the patients were followed up for three, all patients were hospitalized in our gynecologic surgery and postoperative pathologic do 2 cases for la period,1 case of Ib period.Conclusion:1.the degree of cervical "erosion" has nothing to do with the CIN grade.2. colposcopiccervical biopsy of ASC-US has important diagnostic value.3. ASC-US has importantclinical value, high-grade CIN may be found in the first signal. |
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