217077名妇女乳腺癌筛查结果分析  

A study on breast cancer screening for 217 077 women and the screening protocol employed

作　　者：程兆明[1] 蒋光愉[2] 曾颖[3] 孙晓霞 何造雄 许涛 王唯[3] 茜洛钢 黄江萍 刘璇 危丽梅 何文山[3] 刘睦宇 赵雪影 司徒锐[1] 马萍芳 余森泉 

机构地区：[1]暨南大学医学院,广州510632 [2]暨南大学附属第一医院 [3]深圳市计划生育服务中心 [4]珠海市人口和计划生育服务中心 [5]佛山市人口和计划生育服务中心 [6]广东省计划生育专科医院

出　　处：《中华普通外科杂志》2016年第4期328-332,共5页Chinese Journal of General Surgery

摘　　要：目的调查乳腺癌的发病情况，探讨适宜的乳腺癌社区筛查模式。方法按照多阶段随机分层、整群抽样的方法，在广东省珠江口的四座城市为部分妇女筛查乳腺癌。筛查分初筛和精筛二轮实行，包括问卷表调查、乳腺临床检查、乳腺X线摄片和乳腺高频B型超声波检查等；组织病理学诊断为确诊的金标准；乳腺癌检出率为研究终点。结果共筛查217077人，中位年龄为36岁（20-69岁），平均普查率75．23％，4市共筛检出乳腺癌166例（76．47／10万）。乳腺癌粗检出率以深圳市（96．44／10万）和珠海市（95．14／10万）为高，佛山市最低（23．91／10万）（χ^2=27．808，P=0．000；χ^2=24．895，P=0．000）。各年龄组的标化检出率呈双峰型分布，30—39岁为发病高峰期（84．62／10万），50-59岁组（57．16／10万）尚另有一低峰。筛检出的乳腺癌中无临床Ⅱa期以上者。结论珠江口部分城市女性乳腺癌的筛查检出率颇高，发病年龄提前;乳腺钼靶X线摄片结合高频B型超声波诊断和乳腺临床检查的筛查模式比较适合城市的社区集体筛查，可达早期诊断的目的。Objective To explore the current prevalence of female breast cancer in four cities around the Pearl-River Delta and to comment upon the validity of breast cancer screening protocol. Methods The candidates were randomly collected by cluster sampling through multistage samplings. The program included initial screening and early recall incident assessment by questionnaire, clinical breast examination, mammography, B-ultrasound and histopathology study. The histopathology evidence was the golden standard for diagnosis and the detection rate of breast cancer was the endpoint of this study. The partition of χ^2 method was adapted for the statistical analysis. Results 217 077 women from various communities in the cities Shenzhen, Zhuhai, Foshan and Guangzhou were screened with a median age 36 years old （20 - 69）. The average uptake rate of the screening was 75.23 %. The total average breast cancer detection rate was 76.47/10^5 （ 166/217 077 ）. The high breast cancer crude detection rates of 96. 44/10^5 （94/97 473） from Shenzhen and 95.14/10^5 （55/57 811 ） from Zhuhai were explored, whereas 23.91/10^5 （ 14/58 541 ） from Foshan was the lowest one （χ^2 = 27. 808, P = 0. 000 ;χ^2 = 24. 895, P = 0. 000 ）. Presenting as an age distribution, the age-bracket 30 to 39 had the highest standardized detection rate of 84. 62/10^5 （ 99/92 679 ）, followed by 57.16/105 （ 10/16 489） from the 50 - 59 aged group as the second（χ^2= 2. 992, P = 0. 084）. None of them was found as stage Ⅱa and above. Conclusion The current detection rate of female breast cancer in some cities around the Pearl-River Delta is rather high and the victims of the disease tend to shifting to younger women. The protocol of mammography screening associated with B-ultrasound and clinical breast examination for this study could contribute to the early diagnosis, and then is applicable to metropolitan population-based breast cancer screening.

关 键 词：乳腺肿瘤 普查 检出率 筛查模式 

分 类 号：R714.256[医药卫生—妇产科学]