Hong Kong Dermatology & Venereology Bulletin

Volume 12 Number 1, Spring 2004

Interpretation of Pap smear reports

TH Cheung 張德康

Pap smear screening is a multi-step process that involves recruitment of patients, taking smear, making and reading slides and issuing reports to alert clinicians to take appropriate action. In the last decade, innovative technologies including liquid base cytology, automated screening and human papilloma virus (HPV) tests have revolutionarised Pap smear screening. As a quality assurance measure to improve Pap smear reports, Bethesda system (BTS) was developed in 1988 to replace Papanicolaou numeric classes. BTS 1988 is structured and descriptive and is well received in many parts of the world including Hong Kong. Minor modifications were made in 1991 (BTS 1991) to improve the system whilst a major revision was made in 2001 to reflect the current understanding of cervical cytology and use of new technologies in Pap smear screening. This paper will discuss the changes that have been made to BTS 2001 to facilitate interpretation of reports and providing appropriate management. (H.K. Dermatol. Venereol. Bull. (2004) 12, 12-17)

子宮頸柏氏塗片普查有多項工作步驟,包括:選取病人,子宮頸塗片,塗片的製作與檢查,以及撰 寫報告以通知臨床醫生採取適當的治療措施。在過去十年,創新技術如液相細胞學,自動篩查法及 人類乳頭狀瘤病毒測試法,均令子宮頸柏氏塗片普查產生革命性變化。為求令柏氏塗片報告的質量 更優良,畢士達系統於1988 年逐步開發,並取代了柏氏計數分類法。1988 年畢士達系統的結構 嚴謹,描述仔細,廣為世界各地及本地業界所採用。此系統於1991 年曾作少許修改。至2001 年 則有大幅修訂,以配合子宮頸細胞學的進展和新科技的應用。

Keywords : Bethesda system, Pap smear


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