? ??????????? ??????? ?????????? ??? ?????????????? ?? ?????? ?????????? ??? HSIL. ASC-H ?? ?????? ?? ????? ?????? ??? ?? ???????????? ????????????? ???? ??????? ???? ??? ?????????? ??? ???? ??????? ???????? ???????? ??? ??????????? ?? HSIL ??? ?? ????? ???????? ???
- HSIL ?????? ?? ????? ??????? ??????? ??? ?????????????? ???????
- ?????????????? ??????????? ?????????? ?????? ?????? ?? ????? ???????????? HSIL ??????? ???? ?????????? ???? ? ?????? ??? ?????????? ??????
- ?? ?????????? ??????? ??????? ?? ?????? ?? ???? ?? ????????? ???????
- ??????? ??????????? ?????? HSIL ??? LSIL ?? ?????? ?? ????????? ?? SIL ???? ?? ASC-H.
???? ???????????? ????? ASC-H ??? ????????? ?? HPV ??????? ???? ? ???????? ????????? ??? ??? ???????????? ???????? ??? ??? ??????????? ???????. [??????? ?? ???????? 12 – ???????????? ?? ??? ??????????????? ??????????]. ??? ?. ???????? ???? ?? ??????? ??????????, ?????????????????? ??? ????????? “????? ??????? ??????? ??? ??? ?????????? HSIL” ?????????? ?? HPV ??????? ??? ?????????? ????? ?????? ? HPV ????????? ????? ??????. ????? ????????? ??? ?? ??? ????????? ?? ??????? ??????????? HSIL ??? ????? HPV-?????????. [??????? ?? ?? ???????? 7 – ??????? ??? HPV tests ???? ?????? ??? ????????]
???? ????? ???????? 3 ?????? ??????????? ???? ?????? ?????????????? ? ????????? ASC-H
- ???? ???????????? ???????
- ?????????????? ??????????? ?????????? ??????
- ???????? ?????? ???????? ????????? ?????????? ??? HSIL
???? ????? ????????? ? ??????? ???????????????? ASC-H ?????? ?? ????? ?? ???????????? ????? ?????????? ??? ??????????? ???? ?????????? HSIL.
???? ??????? ????????? ? ??????? ???????????????? ASC-US ?????? ???? ?? ????? ?? ??? ???????????? ?????????? ??? ??????????? ??? ?????? look-alikes ??? ?????????????? ?????????? ?????????? ??????: ??????? ???????????, ????????-?????????????? ?????????, ???????????? ????????????? ??????? ??? CGIN. ??????????? ?? ??????? ????????????? ??? ??? ????? ????????? ????? ??? ??????????? ?????? ????? ??? ?????? ??????? ????????? ?? ???????? ???? ???????? ??? HSIL. ??????? ?????????????? ??????????? ?????????? ?????? ???????????? ????????? ?? CIN3 ???? ?? CIN2 ? ???????? ?????? ??? ? NC ???????? ?? ?????? ?? ????? ??????????? ?? HSIL. [??????? ?? ???????? 10 – ???????]
? ????? ????????? ??????? ???????? ??? ?????????? ???????? ?????? ?????? ?? ??????? ??? ?????????? ???????? ???? ???????? ???????? ????????? ??????????, ??? ??????? ????? ?????????? ??????????, ??? ??? «?????????????» ????? HSIL.
??????? ???????? ????????? ?? ???????? ?? HSIL
H ???????? ??? HSIL ??? ??????? ??????? ????????? ?????? ?? ????? ?????? ??????? ?? ??????????? ????? ??? ??????? ??? ‘???????? ???????? ???????????’, ??? ??????? ?? ??????????? ?? LSIL ?? ??????? ?????????? (Duggan et al. 2006). ??????-???????? HPV ??????? ?????? ?? ???????? ???? ???????? SIL ??? ??????? ??????????, p16 ??? Ki-67 ?????? ?????? ?? ????? ??????? ???? ???????? HSIL ??? LSIL. [??????? ?? ???????????? ?? ??? ??????????????? ??????????]
???? ????????????, ? ?????? ??????????? ????? ?????? HSIL ??? ???????? ????????? ?????????? ??? ????????? ??? ??? ???? ??? ??????????, ???????? ??? ????????? ????????? ??? NC ??????? ???? ???? ??? ??????????.
???????????? ??? ??????? 9c-16, 17 ??? 18 ???????????? ??? ???????? ASC-H.
????? 9c-16 (a-b). ASC-H ?? ??????? ???????????? ???????
(a) ASC-US ????????????? ?? CIN2 ?? ??????
(b) ???? ? ???????? ????????????? ???? ?????????? (review) ??? ??????? ??? ??????? ??? ????????? ?????????????? ??? ?????? ?? ??? ????? ?????????? CIN2. P16INK4 ??? Ki67 (MIB-1) ????? ??????????? ???? ?? ?????????????? ??????????? ???? ????. [??????? ?? ???????? 12 - ???????????? ?? ??? ??????????????? ??????????] HPV ????????? ??????? ?? ????? ??? ?????????.
????? 9c-17 (a-b). ASC-H ?? ???? ????? ???????
(a) ASC-H ????????????? ?? CIN2 ???
(b) ?? CIN3 ??????????
????? 9c-18 (a-b). ASC-H ?? ???????? ??????????.
(a) ????????? ???? ???????? ??????????? ??????? ??? ?????????? ???????????: ???????? ??? ?????? ????? (plate) ???? ????? ?????????????? ????????
(b) ????????? ?????????? ???????????? ??? ??????: ??????? SIL.