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- 宫颈组织
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| 姓 名： | ××× | 性别： | 女 | 年龄： | 45岁 |
| 标本名称： | 全切子宫 | ||||
| 简要病史： | 子宫腺肌症，CIN1-2(上级医院会诊结果) | ||||
| 肉眼检查： | 宫颈中度糜烂 | ||||
CIN1累腺？？
看到此例病例，恍然大悟，似乎真正的理解了“LSIL的异型性（核增大，核深染）主要发生在中层和表层上皮”，也更好的理解了关于细胞学中LSIL的诊断标准。而我们从入门无论是书上还是老师都是讲的是细胞结构异型性上皮1/3以下为CIN1，1/3-2/3为CIN2，大于2/3为CIN3。
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This is a typical CIN1 lesion. Based on her age 45 year old, she will have higher potential in progressing to high grade lesion CIN2+, therefore, she should have HPV test and should be closed followed with PAP cytology every 6-12 months if HPV test is positive.
Now can anybody tell me the scenario if her HPV test is negative? and what will you do then if she is negative for HPV?
- 不坠青云之志，长怀赤子之心
| 以下是引用杨斌在2009-7-27 1:24:00的发言：
This is a typical CIN1 lesion. Based on her age 45 year old, she will have higher potential in progressing to high grade lesion CIN2+, therefore, she should have HPV test and should be closed followed with PAP cytology every 6-12 months if HPV test is positive. Now can anybody tell me the scenario if her HPV test is negative? and what will you do then if she is negative for HPV? |
- 三人行，必有我师焉，择其善者而从之，择其不善者而改之。
| 以下是引用向您学习在2009-7-27 17:43:00的发言：
That is correct. About 15% of CIN1 is caused by low-risk HPV infection. If HPV test is negative, it is most likely this patient's CIN1 is caused by low-risk, not by high-risk HPV. Therefore, she will be in a low risk in progressive to CIN2+ lesion. A follow up in 12 months should be good enough.
Of course, this patient has already done hysterectomy and do not need HPV test. I just use this case to stimulate you thinking of different clinicopathologic scenario and exercise your brain cells for fun. Also, it will add some knowledge for you to communicate with clinicians in case question like this is asked. |
- 不坠青云之志，长怀赤子之心
