广西农村妇女宫颈癌及癌前病变筛查结果分析  

The result analysis of cervical cancer and precancerous lesions screening for rural women in Guangxi

作　　者：刘湘红[1] 曾萼[1] 韦朋海 韦萍[1] 姚慧[1] 

机构地区：[1]广西壮族自治区妇幼保健院,广西南宁530003

出　　处：《中国热带医学》2017年第11期1093-1097,共5页China Tropical Medicine

基　　金：广西医药卫生自筹经费计划课题项目(No.Z2014570)

摘　　要：目的了解不同的筛查方法对宫颈癌和癌前病变检出率的影响,以及在不同民族、年龄和文化程度等方面的分布特点。方法采用χ~2检验和Fisher确切概率法,对用不同筛查方法筛出的宫颈癌和癌前病变患者的发病情况进行比较分析,并对其初筛结果、民族、年龄和文化程度的分布进行统计分析。结果采用人乳头状瘤病毒(humanpapillomavirus,HPV)联合液基薄层细胞学技术(thinprep cytologic test,TCT)所筛出的宫颈癌和癌前病变检出率高于仅用TCT进行筛查的检出率,差异具有统计学意义(P<0.05);低级别宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN1)患者初筛结果中不典型鳞状上皮细胞(atypical squamous cells of undetermined signification,ASC-US)比例最高,高级别宫颈上皮内瘤样病变(CIN2、CIN3)、原位腺癌(adenocarcinoma in situ,AIS)、微小浸润癌和浸润癌患者初筛结果均为高度鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)的比例最高;宫颈癌前病变患者在35~44岁、汉族、初中文化程度的妇女中比例最高,宫颈癌患者在45~54岁、汉族、初中文化程度的妇女中比例最高。结论 HPV联合TCT筛查的方法能有效提高宫颈癌和癌前病变的检出率;在不断探索和总结更为经济有效的筛查方案的同时,各地应因地制宜,加强对高危人群的宣教和跟踪随访,切实提高宫颈癌的早诊早治率。Objective To investigate the influence of different screening methods on the detection rate of cervical cancer and precancerous lesions, as well as the distribution characteristics of different nationalities, ages and educational levels. Methods Theχ2 test and Fisher＇s exact probability method was adopted, the incidence of cervical cancer and precancerous lesions screened by different screening methods and to analyse the distribution of preliminary screen result, nationality, age and education level statistically. Results The cervical cancer and precancerous lesion detection rate screened with the method of human papillomavirus （HPV） combined with thinprep cytologic test （TCT） was higher than the detection rate of screening with only TCT, the difference was statistically significant （P 〈 0.05） ; Low level cervical intraepithelial neoplasia pathological changes（ CIN1 ） patients preliminary screen result in the highest proportion of atypical squamous cells （ASC-US）, high level cervical intraepithelial neoplasia pathological changes（CIN2, CIN3）, preliminary screen result of carcinoma in situ （AIS）, microinvasive carcinoma and invasive carcinoma in the highest proportion of high grade squamous intraepithelial lesion （HSIL）. Cervical precancerous lesions patients in the highest proportion of the 35-44 years old, Han Nationality, junior high school education women, cervical cancer patients in the highest proportion of the 45-54 years old, Han Nationality, junior high school education women. Conclusion HPV combined with TCT screening method can improve the detection rate of cervical cancer and precancerous lesions;While continuing to explore and summarize a more cost-effective screening program, we should strengthen the high-risk population education and follow-up, and effectively improve the cervical cancer early diagnosis and early treatment.

关 键 词：宫颈癌 癌前病变 农村妇女 筛查 

分 类 号：R737.33[医药卫生—肿瘤]