北京地区已婚妇女宫颈病变相关因素分析  

Analysis of correlation factors for cervical intraepithelial neoplasia in married women in Beijing, China

作　　者：李长东[1] 张为远[2] 张凇文[4] 武明辉[4] 王建东[3] 

机构地区：[1]首都医科大学附属北京妇产医院妇科微创中心,100026 [2]首都医科大学附属北京妇产医院妇产科,100026 [3]首都医科大学附属北京妇产医院肿瘤科,100026 [4]北京妇幼保健院

出　　处：《中华医学杂志》2010年第3期196-200,共5页National Medical Journal of China

基　　金：基金项目：北京市科委重大项目（D0906008040491）;北京科技新星计划（2006A66）

摘　　要：目的掌握北京地区已婚妇女宫颈病变（CIN）的发病特点及相关影响因素。方法采用横断面调查方法，于2007年3月至2008年9月对北京地区12个区县共137个社区内随机抽取25～54岁已婚育龄妇女6339例，进行问卷调查，妇科检查，宫颈涂片液基细胞学检测、宫颈分泌物高危型人乳头瘤病毒（HR—HPV）检测，并对宫颈细胞学异常者行阴道镜检查及活检。结果（1）6339例调查对象，宫颈病变患者374例，患病率为5．9％；（2）在细胞学阳性的调查者中，随着细胞学异常级别的升高，宫颈病变发生率也升高；（3）30—34岁是北京地区宫颈病变的发病高峰年龄，尤其是高度病变的发病高峰；（4）HR．HPV感染率9．9％，细胞学检查阳性者HR—HPV感染率为41．2％，明显高于细胞学阴性者的感染率6．6％；（5）HR—HPV感染率随宫颈病变级别升高而提高，HR-HPV负荷量也呈逐渐增高趋势。结论30～34岁为北京地区已婚妇女宫颈病变的高发年龄，HR—HPV感染是其患病的独立风险因素。宫颈细胞学检查可以早期提示宫颈病变的发生。应通过对已婚妇女的联合筛查及时发现宫颈病变，及时治疗，阻断宫颈癌的发生。Objective To investigate the characteristic of precancerous conditions of cervical intraepithelial neoplasia （CIN） and its related high-risk factors among the married women in Beijing, China. Methods Based upon the method of cross-sectional survey, 6339 married women at reproductive age from 25 to 54 years old were selected randomly in a total of 137 communities of 12 districts or counties in Beijing from March 2007 to September 2008. The interview was carried out with unified questionnaires and gynecological examinations. And the cervical Pap smear was used for liquid-based cytological examination and the cervical secretion for detection of high-risk human papillomavirus （HPV） DNA. Furthermore, the women with abnormal cervical cytology received colposcopy and cervical biopsy. Results （ 1 ） Among 6,339 study subjects, 374 cases had CIN and the prevalence rate was 5.9% ; （ 2 ） For the cases with cervical cytology positive results, cervical biopsy showed an elevated level of abnormal cytology and an increased incidence of cervical lesions; （3）The peak age of CIN prevalence was 30 to 34 years old and there was a high grade of cervical neoplasia; （4） Among the population, the infection rate of high-risk HPV was 9. 9% and the infection rate of high-risk HPV in positive cytological group （41.2%） was significantly higher than that in negative cytological group （ 6. 6% ） ; （ 5 ） The infection rate and DNA load of high-risk HPV increased following the severity grade of CIN. Conclusion In Beijing, married women at 30 to 34 years old are the high-risk group in CIN incidence and the infection of high-risk HPV is an independent risk factor. Liquid- base cvtology combined with high-risk HPV DNA test is a viable method to discover CIN in time and orevent the incidence of cervical cancer.

关 键 词：宫颈上皮内瘤样病变 癌前状态 危险因素 流行病学 

分 类 号：R737.33[医药卫生—肿瘤]