中国大陆部分地区宫颈癌治疗前盆腔影像学资料缺失调查分析  

Investigation and analysis of the utilization of pelvic imaging examinations before treatment for cervical cancer in some parts of China's Mainland

作　　者：李翠梅 Oldevie Hugueth Ognami 廖科丹[2] 刘萍[2] 霍智锋[2] 杨鹰 赵卫东[4] 康山 王武亮 郝敏[7] 陈春林[2] 郎景和 LI Cui-mei;Oldevie Hugueth Ognami;LIAO Ke-dan;LIU Ping;HUO Zhi-feng;YANG Ying;ZHAO Wei-dong;KANG Shan;WANG Wu-liang;HAO Min;CHEN Chun-lin;LANG Jing-he(Department of Obstetrics and Gynecology, Heyuan Women ＆ Children＇ s Hospital, Heyuan 517000, China)

机构地区：[1]河源市妇幼保健院妇产科,广东河源517000 [2]南方医科大学南方医院妇产科,广东广州510515 [3]陆军军医大学新桥医院妇产科,重庆400037 [4]安徽省肿瘤医院妇产科,安徽合肥236048 [5]郑州大学第二附属医院妇产科,河南郑州450042 [6]河北医科大学第四医院妇产科,河北石家庄050011 [7]山西医科大学第二医院妇产科,山西太原030001 [8]中国医学科学院北京防和医学院北京协和医院妇产科,北京100730

出　　处：《中国实用妇科与产科杂志》2018年第6期666-670,共5页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：十二五国家科技支撑计划(2014BAI05B03); 国家自然科学基金(81272585,81370736,81571422); 广州市科技计划(158100075); 南方医科大学高水平建设临床研究重点项目(LC2016ZD019)

摘　　要：目的分析中国大陆部分地区宫颈癌患者治疗前盆腔影像学资料缺失情况。方法收集2004—2016年中国大陆11个省市的34家医院经宫颈活检诊断为宫颈癌的27 128例患者的临床资料,分析治疗前盆腔影像学检查包括超声及高级影像学检查(CT、MRI、PET-CT)的应用情况及缺失原因。结果 (1)宫颈癌患者治疗前未行任何盆腔影像学检查(简称未行检查)者占20.2%,仅行超声检查者占39.8%,行任何1项或联合2、3项高级影像学检查(简称高级影像学检查)者占40.0%。(2)不同FIGO分期高级影像学检查缺失病例中,Ⅰ期占51.3%,Ⅱ~Ⅳ期占41.6%,分期不详占7.1%。(3)不同城市中,一线城市的Ⅰ期、Ⅱ~Ⅳ期高级影像学检查缺失比例最高,分别为70.3%、58.4%;三线城市的最低,分别为41.5%、55.4%。(4)不同医院中,肿瘤医院的Ⅰ期、综合医院的Ⅱ~Ⅳ期患者的高级影像学检查缺失比例最高,分别为65.2%、60.3%;妇幼医院的最低,分别为48.1%、32.3%。结论 2004—2016年间,总体上中国大陆部分地区的宫颈癌患者治疗前盆腔影像学检查缺失严重,高级影像学检查缺失病例中Ⅱ~Ⅳ期占41.6%,以一线城市、综合医院最为明显,这可能与部分医生凭经验诊治宫颈癌有关,因此引导临床医生认识影像学检查的重要性非常重要。To analyze the pre-treatment utilization of pelvic imaging examinations among patients with cervical cancer in some areas in China's Mainland.Methods Collect the clinical data of 27 128 patients with cervical cancer diagnosed by cervical biopsy,and analyze the utilization of pelvic imaging examination prior to treatment,including ultrasonography and advanced imaging examinations（computer tomagraphy,magnetic resonance imaging and PET-CT）.Results Of a total of 27 128 cases of cervical cancer patients who were incuded in this study,20.2% did not receive any pelvic imaging examination before treatment;39.8% only received ultrasound examination;40.0% received one or a combination of two or three advanced imaging examinations.Among patients without advanced imaging examination in different FIGO stages,stage I accounted for 51.3%,stage Ⅱ-Ⅳ accounted for 41.6%,and unknown stages 7.1%.Among different cities,the first-line cities had the highest proportion of patients without advanced imaging examinations at stage I and stages Ⅱ-Ⅳ,being 70.3% and 58.4%,respectively,and the third-tier cities were the lowest,41.5% and 55.4%,respectively.Among different hospitals,patients with stageⅠin tomor hospitals and stagesⅡ-Ⅳ in general hospitals had the highest proportion of cases without advanced imaging examinations,65.2%and 60.3%,respectively,and the lowest was in Women and Children＇s Hospitals,48.1% and 32.3%,respectively.Conclusion From 2004 to 2016,on the whole,the proportion ofcervical cancer patients in some parts of China's Mainland who don＇t receive preoperative pelvic imaging examinations is quite high,and 41.6% of patients without advanced imaging examinations are in stage Ⅱ-Ⅳ,most notably in first-line cities and general hospitals. It may be related to the fact that some cases of cervical cancer are managed by the doctor＇s own experience,so it is very important to guide clinicians to understand the importance of imaging examination.

关 键 词：宫颈癌 影像学检查 应用情况 

分 类 号：R737.3[医药卫生—肿瘤]