2005年中国12家医院宫颈癌机会性筛查资料分析  

Opportunistic Screening for Cervical Cancer in 12 Hospitals in China

作　　者：屠铮[1] 徐爱娣[2] 卞美璐[3] 吴瑞芳[4] 钱德英[5] 赵健[6] 耿力[7] 李隆玉[8] 李力[9] 周琦[10] 洪颖[11] 刘玉玲[12] 魏丽惠[1] 

机构地区：[1]北京大学人民医院,北京100044 [2]上海市江湾医院虹口区宫颈疾病中心,上海200086 [3]北京中日友好医院,北京100029 [4]北京大学深圳医院,广东深圳518036 [5]广东省人民医院,广东广州510080 [6]北京大学第一医院,北京100034 [7]北京大学第三医院,北京100191 [8]江西省妇幼保健院,江西南昌330006 [9]第三军医大学大坪医院,重庆400042 [10]重庆市肿瘤医院,重庆400030 [11]南京大学医学院附属鼓楼医院,江苏南京210008 [12]郑州大学第二附属医院,河南郑州450014

出　　处：《实用妇产科杂志》2009年第5期278-281,共4页Journal of Practical Obstetrics and Gynecology

基　　金：中国癌症基金会宫颈病变临床诊疗中心协作网组织的"医院妇科门诊宫颈病变检查及诊治方案研究"项目

摘　　要：目的:探讨中国不同地区进行宫颈癌机会性筛查的价值。方法:收集分析2005年全国12家医院门诊进行宫颈癌机会性筛查(opportunistic screening,OS)的资料,筛查方法包括液基细胞学、巴氏细胞学、高危型HPV检测,以及中国癌症基金会推荐的Ⅰ方案(液基细胞学检查加高危型HPV DNA检测)、Ⅱ方案(巴氏涂片加高危型HPV DNA检测)、Ⅲ方案(醋酸白肉眼检查法);并经阴道镜检查,病理确诊宫颈病变及宫颈癌。结果:共收治门诊患者1242952例次,其中接受OS202231例次,占门诊例次16.27%。筛查方法依次为液基细胞学84082例(41.58%),巴氏细胞学79426例(39.27%),Ⅰ方案23658例(11.70%),Ⅱ方案6504例(3.22%),检测HPV筛查者5976例(2.96%);Ⅲ方案2585例(1.28%)。最普遍采用的筛查方法是细胞学检查(液基及巴氏方法)占95.76%。检出宫颈癌前病变(CINⅠ+CINⅡ+CINⅢ)共5146例(2.54%),宫颈癌1134例(0.56%)。结论:医院内就诊人群宫颈病变检出率高,应高度重视其机会性筛查,及时进行规范性治疗。Objective：To evaluate the current opportunistic screening （OS） in diagnosis of cervical cancer and pre-cancer in Chinese hospitals. Methods： OS data from 12 hospitals was collected and analyzed in 2005. Six protocols were used for OS： liquid-based cytology, classical Pap smear, HPV-DNA test, Protocol Ⅰ recommended by Cancer Foundation of China （liquid-based cytology and HPV-DNA test）, Protocol Ⅱ （classical Pap smear and HPV- DNA test）, Protocol Ⅲ （vision inspection with acetic acid, VIA）. All the suspected cases underwent colposcopy and biopsy. Each case of cervical lesion or cervical cancer was confirmed pathologically. Results： A total of 1242952 women came to the outpatient department of the 12 hospitals in 2005 and 202231 （16.27%） of them received OS： 84082 （41.58%） by liquid-based cytology, 79426 （39.27%） by classical Pap smear, 23658 （11.70%） by Protocol Ⅰ, 6504 （3.22%） by Protocol Ⅱ, 5976 （2.96%） by HPV-DNA test, 2585 （1.28%） by Protocol Ⅲ. Cervical cytology （liquid-based and classical Pap smear） was the most commonly used in screening（95.76%）. Cervical lesions pre-cancer were diagnosed in 5146 cases （2.54%） and cervical cancer in 1134 （0.56%）.Conclusions：As the prevalence, of cervical cancer or pre-cancer is high among the women who visit hospitals for gynecologic diseases, opportunistic screening should be highly recommended so as to diagnose and treat cervical cancer and pre-cancer properly and timely.

关 键 词：机会性筛查 宫颈癌 宫颈病变 宫颈细胞学 人乳头瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]