Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press18110.17650/1994-4098-2011-0-3-74-78GYNECOLOGY. DIAGNOSISГИНЕКОЛОГИЯ. ДИАГНОСТИКАAbnormal cervical smears in the unchanged uterine cervix: difficulties in the screening, diagnosis, and treatment of cervical intraepithelial neoplasias and microinvasive cancerАномальные цервикальные мазки при неизмененной шейке матки: трудности скрининга, диагностики и лечения цервикальных интраэпителиальных неоплазий и микроинвазивного ракаKorolenkovaL. I.КороленковаЛ. И.
Russian Federation
l.korolenkova@mail.ruN.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, MoscowРОНЦ им. Н.Н. Блохина РАМН, Москва140820113747818082014180820142011https://ojrs.abvpress.ru/ojrs/article/view/181

The author analyzes an algorithm for identifying and treating w omen with cervical intraepithelial neoplasias (CIN) and microinv asive cancer of the cervix uteri in cases of the hidden area of transformation and in the absence of visible cervical changes. There are excep- tional difficulties of making the diagnosis of epithelial damages due to the incomplete reproducibility of cytological abnormal ities and the low informative value of a histological study of scrapes from the cervical canal. To avoid hypodiagnosis, it is justifiable to prefer human papillomavirus testing (Hybrid Capture 2 (HC2)) to repeat smears for the choice of a management tactic. Conization is recommend ed as a diagnostic and/or therapeutic procedure when the viral load is high in over 35-year-old patients with abnormal smears anda hidden transformation area.

Проанализирован алгоритм выявления и лечения женщин с цервикальными интраэпителиальными неоплазиями (CIN) и микро- инвазивным раком шейки матки при скрытой зоне трансформации и отсутствии видимых изменений шейки. Отмечены исклю- чительные трудности в диагностике эпителиальных повреждений из-за неполной воспроизводимости аномальных результатов цитологического исследования и низкой информативности гистологического исследования соскоба цервикального канала. Для вы- бора тактики ведения обоснованным представляется предпочтение повторным мазкам ВПЧ-тестирования (Hybrid Capture 2 — НС2) во избежание гиподиагностики. При высокой вирусной нагрузке больным старше 35 лет с аномальными мазками и скрытой зоной трансформации рекомендована конизация в качестве диагностической и (или) лечебной процедуры.

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