绝经后妇女宫颈病变的特点及其早期诊断  

The characteristics and early diagnosis of cervical lesions in postmenopause women.

作　　者：王丽娜[1] 耿力[1] 郭艳利[1] 周羡梅[1] 沈晓野[1] 姚艳君[1] 范晓红[1] 

机构地区：[1]北京大学第三医院妇产科,100083

出　　处：《中国实用妇科与产科杂志》2004年第12期726-728,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨绝经后妇女宫颈病变的特点、筛查的必要性及早期诊断。方法　对北京大学第三医院自2 0 0 1年 1月至 2 0 0 4年 1月因宫颈涂片异常或临床检查可疑宫颈病变者 934例进行总结分析。根据绝经与否分为未绝经组和绝经组 ,对患者行宫颈涂片、阴道镜下宫颈多点活检。结果　未绝经组及绝经组宫颈异常涂片的检出率分别为 6 8 2 6 % (40 0 / 5 86 )及 85 31% (2 73/ 32 0 ) ,二组比较差异有显著性意义 (P <0 0 5 )。阴道镜下宫颈活检组织病理学诊断宫颈上皮内瘤变 (cervicalintraepithelialneoplasia ,CIN)分别为 2 4 34% (138/ 5 6 7)及 15 0 6 %(5 0 / 332 ) ,二组比较差异有显著性意义 (P <0 0 5 ) ;其中CINⅢ的检出率分别为 8 99% (5 1/ 5 6 7)及 8 73%(2 9/ 332 )。未绝经组与绝经组涂片及组织病理学提示人乳头瘤病毒 (humanpapillomavirus ,HPV)感染共 138例 ,其中高危型HPV阳性率分别为 6 2 2 2 % (5 6 / 90 )和 4 3 75 % (2 1/ 4 8) ,二组比较差异有显著性意义 (P <0 0 5 )。结论　为早期发现宫颈病变 ,阻遏疾病进展为宫颈癌 ,在绝经后妇女进行宫颈细胞学筛查是必要的。Objective To discuss the characteristics and necessities of the screening for cervical les ions in postmenopause women. Methods 934 cases of abnormal smears or abnormal clinical signs were studied according to premenopause group(594 cases) and postmenopause group(340 cases),then co lposcopy and biopsy were done.Results In these two groups,the percentage of women with abnormal smear was 68.26%(400/ 586) and 85.31%(273/320) respectively,P<0.05;the cervical intraepithelia l neoplasia( CIN)detected by histopathology was 24.34%(138/567) and 15.06%(50/332),P<0 .05,and CINⅢ was 8.99%(51/567)and 8.73%(29/332),P>05,respectively .HPV infection was detected by cytology and histopathology in 138 cases out of 9 34,and the high risk HPV DNA detected by HC-Ⅱ was 62.22%(56/90) and 43.75%(2 1/48) in premenopausal and postmenopausal group,P<0.05.Conclusion In order to detect cervical lesions in postmenopause women as early as possible, the routine cytological screening should be done.

关 键 词：绝经期 阴道镜 人乳头瘤病毒 宫颈病变 妇女 宫颈细胞学 

分 类 号：R711.74[医药卫生—妇产科学]