宫颈癌筛查8463例结果分析  

Analysis on the Results of 8463 Cases in Cervical Cancer Screening

作　　者：伍军平[1] 罗新[1] 吴小花[2] 

机构地区：[1]暨南大学附属第一医院妇产科,广东广州510630 [2]暨南大学附属第一医院病理科,广东广州510630

出　　处：《中华妇幼临床医学杂志（电子版）》2011年第3期161-165,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：卫生部医药卫生科技发展中心项目(WKJ2007-3-001)~~

摘　　要：目的探讨宫颈癌筛查中不同检查方法的临床应用价值。方法 按照宫颈癌"三阶梯"筛查方案,对2007年1月至2010年12月在暨南大学附属第一医院接受宫颈癌筛查的8463例女性个体的筛查结果进行统计学分析(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。结果 8463例受试者的宫颈细胞学结果≥未明确诊断意义的不典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASCUS)检出率为3.06%(259/8463),≥高级别宫颈鳞状上皮内瘤变(high-grade intraepithelial lesion,HSIL)检出率为0.67%(57/8463)。1380例接受人乳头状瘤病毒(human papilloma virus,HPV)检测受试者的人乳头状瘤病毒感染率为32.17%(444/1380),其中高危型人乳头状瘤病毒(high-risk humanpapilloma virus,HR-HPV)感染率为27.32%(377/1380),低危型人乳头状瘤病毒(low-risk humanpapilloma virus,LR-HPV)为4.86%(67/1380);HPV-16,-58,-52,-53和-33型等5种最常见的高危型人乳头状瘤病毒感染率分别为33.16%(125/377),21.22%(80/377),20.16%(76/377),10.61%(40/377)和9.55%(36/377)。760例接受阴道镜检查的受试者中,阴道镜检查异常检出率为42.50%(323/760)。371例接受组织病理学检查者,结果正常为10.24%(38/371);慢性宫颈炎及鳞状上皮化生为34.77%(129/371);宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅰ为21.02%(78/371),CINⅡ为13.48%(50/371),CINⅢ为14.82%(55/371),宫颈癌为5.66%(21/371)。其中宫颈癌及癌前病变检出率为44.20%(164/371)。其中,高度上皮瘤变(≥CINⅡ)检出率为31.54%(117/371)。结论 按照"三阶梯"方案进行宫颈癌筛查,应制定个体化筛查方案。Objective To evaluate the clinical application of different approaches in cervical cancer screening. Methods From January 2007 to December 2010, a total of 8463 women who received cervical the cancer screening at First Affiliated Hospital of Jinan University according to three-step technique were recruited into this study. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the First Affiliated Hospital of Jinan University. Informed consent was obtained from all participants. Results The positive rate of ≥atypical squamous cells of undetermined significance（ASCUS） was 3.06 % （259/8463）, anti, high-grade intraepithelial lesion（HSIL） was 0.67 % （57/8463） in the results of Thin prep cytologic test（TCT） of 8463 participants. The rate of human papilloma virus（HPV） infection was 32.17% （444/1380）with 1380 participants received genital human papilloma viral detection, included high-risk human papilloma virus（HR-HPV） was 27.32% （377/1380） and low-risk human papilloma virus （LR-HPV） 4.86%（67/1380）. The positive rate of the most commongenotypes HPV-16,-58,-52,-53 and -33 were 33.16%（125/377）,21.22% （80/377）,20.16% （76/377）,10.61% （40/377）and 9.55% （36/377）, respectively. 760 participants received colposcopy and the positive rate was 42.50% （323/760）, while 371 biopsy specimens were obtained. The normal cervix pathological examination was 10.24% （38/371）, chronic cervicitis and metaplasia of squamous epithelium was 34. 77% （129/371）, cervical intraepithelial neoplasia （CIN） I was 21.02% （78/371）,CIN Ⅱwas 13.48% （50/371）, CINⅢ was 14.82% （55/371）and cervical cancer was 5. 66% （21/371）. The positive rate of cervical cancer, precancer and high-grade cervical intraepithelial neoplasia were 44. 20% （164/371）and 31. 54% （117/371）respectively. Conclusion The cytologic test, genital human papilloma virus detection, colposcopy and biopsies are suitable approach for cervical cancer s

关 键 词：宫颈癌筛查 新柏液基细胞学试验 人乳头瘤病毒 基因型 阴道镜 

分 类 号：R737.33[医药卫生—肿瘤]