婆媳、妯娌共患子宫颈上皮内瘤变3例报告

栾娟 徐广萍 周旋

[摘要] 液基薄层细胞学检查（TCT）能早发现宫颈上皮内瘤变（CIN）。本文报道3例：一家婆母TCT首次示意义不明的不典型鳞状细胞（ASCUS），15个月后示宫颈高度鳞状上皮内瘤变（HSIL），后确诊宫颈癌。其大儿媳、二儿媳TCT均示宫颈低度鳞状上皮内瘤变（LSIL），阴道镜活检病理示CINⅡ～Ⅲ，行宫颈环形电切除术（LEEP），皆孕足月剖宫产，被提出婆母、妯娌都患有CIN，这是否与男性遗传有关有待验证。若TCT有问题，不仅女方直系亲属要查，男方直系亲属的配偶也要查，因为他们都是高危人群。要重视ASCUS的处理，对生殖道感染者的配偶也要同时规范对症治疗，以阻断CIN的发生及发展。

[关键词] 婆媳、妯娌；宫颈上皮内瘤变；液基薄层细胞学检查；男性遗传

[中图分类号] R737.3 [文献标识码] A [文章编号] 1674-4721（2016）03（c）-0167-04

[Abstract] Liquid based thin-layer cytology test （TCT） can find cervical intraepithelial neoplasia （CIN） early.This paper reported 3 cases： TCT of a mother-in-law first showed equivocal atypical squamous cells （ASCUS），height of cervical squamous intraepithelial neoplasia （HSIL） was showed after 15 months and then cervical cancer was diagnosed.Low of cervical squamous intraepithelial neoplasia （LSIL） was showed from the TCT of her old daughter-in-law and small？daughter-in-law，CINⅡ-Ⅲ were showed from the pathology of colposcopy histopathology and full-term pregnancy cesarean delivery were conducted by using LEEP.This shows that all of mother-in-law and sister-in-law have CIN whether involves in male genetic need to test and verify.If the TCT have problems，not only the immediate family members of women need to check but also spouses of men immediate family members.Because they are at high risk.The dealing with ASCUS should be paying more attention and standardize symptomatic treatment also should be used to spouses of reproductive tract infections to block happening and development of the CIN.

[Key words] Mother-in-law and sister-in-law；Cervical intraepithelial neoplasia；Liquid based thin-layer cytology test；Holandric inheritance

子宫颈上皮内瘤变（CIN）是与子宫颈浸润癌密切相关的一组子宫颈病变，常发生于25～35岁妇女。大部分低级别CIN可自然消退，但高级别CIN具有癌变潜能，可能发展为浸润癌，被视为癌前病变。CIN反映了子宫颈癌发生发展中的连续过程，通过筛查发现CIN，及时治疗高级别病变，是预防子宫颈癌行之有效的措施[1]。早期诊断宫颈癌及CIN是提高宫颈癌治愈率及患者生存率的关键。子宫颈细胞学检查是CIN及早期子宫颈癌筛查的基本方法。而薄层液基细胞学检查（TCT）所制备单层细胞涂片效果清晰，阅片容易[1]，检查准确率高，达67.0%～92.6%。临床上遇到一家婆母TCT首次示意义不明的不典型鳞状细胞（ASCUS），15个月后示宫颈高度鳞状上皮内瘤变（HSIL），确诊为宫颈癌。其大儿媳、二儿媳TCT均示宫颈低度鳞状上皮内瘤变（LSIL），阴道镜活检病理示CINⅡ～Ⅲ，行宫颈环形电切除术（LEEP）治疗，皆孕足月剖宫产。……