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首页> 外文期刊>Acta Cytologica: The Journal of Clinical Cytology and Cytopathology >Eliminating the diagnosis atypical squamous cells of undetermined significance: impact on the accuracy of the Papanicolaou test.
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Eliminating the diagnosis atypical squamous cells of undetermined significance: impact on the accuracy of the Papanicolaou test.

机译：消除对诊断非典型鳞状细胞的重要性的不确定性：对Papanicolaou测试准确性的影响。

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OBJECTIVE: To assess eliminating the diagnosis "atypical squamous cells of undetermined significance" (ASCUS) from the Bethesda System for Reporting Cervical/Vaginal Cytological Diagnoses and analyze its impact on the sensitivity and positive predictive value of Pap smears. STUDY DESIGN: A total of 166 previously diagnosed ASCUS cases with follow-up biopsy results available were prospectively downgraded to within normal limits/benign cellular changes or upgraded to specific squamous intraepithelial lesions (SILs) or the malignant category. These review cytodiagnoses were compared with the histologic outcome. The impact on the sensitivity and positive predictive value of Pap smears was also assessed. RESULTS: Though there was a decrease in the sensitivity of the Pap smear from 100% to 76.3% for SIL overall and from 100% to 80% for high grade SIL (HSIL) alone, there was an improvement in the positive predictive value of diagnosing SIL from 46% to 85% and from 6% to 15% for HSIL alone. CONCLUSION: The ASCUS diagnosis can be minimized to a great extent, if not eliminated completely. The "ASCUS-favor reactive" group can be eliminated, while the diagnoses "ASCUS favor SIL" and "ASCUS-not otherwise specified" should be used sparingly.
机译：目的：评估从报告宫颈/阴道细胞学诊断的贝塞斯达系统中消除诊断“具有非确定意义的非典型鳞状细胞”（ASCUS）的诊断，并分析其对宫颈涂片涂片敏感性和阳性预测价值的影响。研究设计：总共166例先前诊断为具有后续活检结果的ASCUS病例被前瞻性降级至正常范围/良性细胞改变或升级为特定的鳞状上皮内病变（SILs）或恶性类别。将这些回顾性细胞诊断与组织学结果进行比较。还评估了对子宫颈抹片检查的敏感性和阳性预测值的影响。结果：尽管巴氏涂片检查的敏感性从整体上来说从100％降低到76.3％，而仅高级SIL（HSIL）从100％降低到80％，但诊断的积极预测价值有所提高仅HSIL的SIL含量从46％增至85％，从6％增至15％。结论：如果不能完全消除ASCUS的诊断，可以在很大程度上将其最小化。可以取消“ ASCUS有利反应性”组，而应谨慎使用“ ASCUS有利SIL”和“ ASCUS-未另作说明”的诊断。

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