山西子宫颈癌筛查方法比较的可行性研究  

A Pilot Study for Cervical Cancer Screening in Shanxi Province

作　　者：杨玲[1] 章文华[1] 李爱玲[1] 潘秦镜[1] 吴令英[1] 李凌[1] 戎寿德[1] 杨雪萍 马聪萍[3] Jerome L Belinson Robert G Pretorius 乔友林[1] 

机构地区：[1]中国医学科学院肿瘤研究所肿瘤医院,北京100021 [2]山西省襄垣县妇幼保健院 [3]山西省阳城县肿瘤医院 [4]美国克里夫兰医学中心妇产科 [5]美国南加州凯瑟医疗系统妇瘤科

出　　处：《中国肿瘤》2000年第9期391-392,共2页China Cancer

基　　金：Taussig肿瘤中心;ClevelandClinic基金会;中国国家教委;加拿大TerryFox基金会;德国CarlZeiss公司基金支持

摘　　要：〔目的〕在同一对象人群中同时比较六种宫颈癌及癌前病变筛查方法 ,并调查影响宫颈癌的危险因素 ,为进一步开展宫颈癌大样本人群的癌前筛查方法比较研究提供简单、可行且高效的依据。〔方法〕在山西宫颈癌高发地区对136位妇女同时采用以组织学为金标准的六种宫颈癌及癌前病变筛查方法筛查。同时 ,对该对象进行宫颈癌危险因素调查。〔结果〕该人群宫颈高度鳞状上皮内瘤变(HSIL)及癌的现患比率为8 8%(12/136)。各筛查方法的敏感度、特异度及准确性为 :3%醋酸染色后肉眼观察(0 250,0 850,0 795)、细胞学常规涂片(0 583,0 958 ,0 924)、ThinPrep涂片(0 818,0 966,0 953)、阴道镜检(0 583,0 825 ,0 803)、HPV自检(0 667 ,0 842,0 826)、ThinPrep检测HPV(0 917,0 853,0 859) ;宫颈荧光检查的敏感度为0 57,其特异度为0 55;该人群对筛查方法的顺应性为100 % ,对危险因素调查的顺应性为95 5 %。〔结论〕根据本可行性研究结果 ,认为该地区确属宫颈癌高发地区 ,且人群顺应性好 ,可以开展大规模的宫颈癌筛查方法的比较研究及危险因素调查研究。purpose〕We conducted a pilot study in rural Shanxi Province to determine disease prevalence,rationality and feasibility in preparation for a large-scale population-based comparative trial of six screening tests of cervical cancer which include gold standard measures of diagnostic accuracy 〔Methods〕One hundred and thirty-six women were screened with six screen methods based on the pathology results as a gold standard and the risk factors were investigated in a questionnaire in high incidencial area,Shanxi province 〔Results〕Biopsies showed the prevalence of HSIL and cancer of cervix was 8 8% Using biopsy result as a gold standard,the sensitivity,specificity and accuracy of each diagnostic test listed as following,visual inspection(0 250,0 850,0 795),conventional Pap smear(0 583,0 958,0 924),ThinPrep Pap(0 818,0 966,0 953)respectively,Colposcopic evaluation(0 583,0 825,0 803),HPV self test(0 667,0 842,0 826),ThinPrep for HPV test(0 917,0 853,0 859)respectively Sensitivity and specificity for fluorescent spectroscoty was 0 57 and 0 55 The compliance for screening methods was 100%,and that for risk factor questionnaire was 95 5% 〔Conclusion〕In general,the proposed large-scale trial is feasible

关 键 词：宫颈肿瘤 筛查 危险因素 癌前病变 山西 可行性 

分 类 号：R737.33[医药卫生—肿瘤]