山东东明县23088名已婚女性宫颈癌筛查结果分析  

Analysis of cervical cancer screening results of 23 088 married women in Dongming County, Shandong Province

作　　者：谢风祥 张丽冉 王新国 赵东曼 彭德志 毕春蕊 姜玲波 赵俊艳[2] 祁德波 Xie Fengxiang;Zhang Liran;Wang Xinguo;Zhao Dongman;Peng Dezhi;Bi Chunrui;Jiang Lingbo;Zhao Junyan;Qi Debo(Jinan Kinked Diagnostics,Jinan 250101,China;People＇s Hospital of Lixia District,Jinan 250014,China)

机构地区：[1]济南金域医学检验中心,250101 [2]济南市历下区人民医院,250014

出　　处：《中华临床实验室管理电子杂志》2018年第3期157-161,共5页Chinese Journal of Clinical Laboratory Management(Electronic Edition）

摘　　要：目的分析山东省东明县已婚女性宫颈癌筛查结果,为该地区宫颈癌预防提供科学依据。方法回顾性汇总分析2016年9月至2017年6月期间,于济南金域医学检验中心病理室行宫颈癌筛查的东明县23 088名已婚女性的细胞学检测结果。年龄范围为19~90岁,分为5组:<30岁组810例、30~39岁组5174例、40~49岁组9301例、50~59岁组5707例、≥60岁组2096例。同时对其中细胞学异常者随访,得到高危型人乳头状瘤病毒(high-risk human papillomavirus,hr HPV)检测结果61例和组织活检结果438例,进行分析。结果 23 088名已婚女性经细胞学检测,检出异常细胞学者1177例(5.1%),其中:不能明确判读的非典型鳞状细胞(atypical squamous cells of unknown significance,ASCUS)者729例(3.2%),不能排除高级别鳞状上皮内病变的非典型鳞状细胞(atypical squamous cells cannot exclude HSIL,ASC-H)/非典型腺细胞(atypical glandular cells,AGC)者43例(0.2%),低级别鳞状上皮内病变(low grade squamous intraepithelial lesions,LSIL)者289例(1.3%),高级别鳞状上皮内病变(high grade squamous intraepithelial lesions,HSIL)者116例(0.5%)。随访细胞学异常者hr HPV检测阳性率为50.0%(31/61例),组织活检阳性率为45.6%(200/438例)。不同年龄组间不同异常细胞学病变阳性率比较,ASC-US(χ~2=5.502,P=0.019)和LSIL(χ~2=3.956,P=0.047)阳性率存在明显差异。ASC-US以50~59岁组197例(3.5%)最高,30~39岁组134例(2.6%)最低;LSIL以<30岁组12例(1.5%)和30~39岁组76例(1.5%)最高,50~59岁组50例(0.9%)最低。不同细胞学病变的组织活检结果有明显差异。活检正常者(χ~2=113.536,P<0.001)在ASC-US中所占比(75.4%)最高,而HSIL所占比(9.8%)最低;活检结果为宫颈上皮内瘤变1(cervical intraepithelial neoplasia,CIN1)(χ~2=37.817,P<0.001)在LSIL所占比(44.4%)最高,而HSIL所占比(6.6%)最低;活检结果为CIN2/3/原位腺癌(adenocarcinoma in situ,AIS)/鳞状细胞癌(squamous cell carcinoma,SCC)(χ~2=603.863,P<0.001)则在AObjective To analyze the cervical cancer screening results of married women in Dongming County of Shandong Province, and to provide scientific evidence for cervical cancer prevention in this region. Methods A retrospective study on the cytological results of 23 088 married women in Dongming County, from September 2016 to June 2017 was performed. Cervical swabs of 23 088 married women were referred to Jinan King Med Diagnostics. The age of these married women is 19~90 years old. They were divided into 5 groups： 810 cases in group 〈30 years old, 5174 cases in group 30~39, 9301 cases in group 40~49, 5707 cases in group 50~59 and 2096 cases in group of over 60 years old. At the same time, 61 cases of high risk human papillomavirus（high-risk human papillomavirus, hr HPV） and 438 cases of abnormal cytology with tissue biopsy were followed up, and analyzed. Results A total of 1177 women（5.1%） were interpreted as cytological abnormalities, including 729 cases（3.2%） of atypical squamous cells of unknown significance（ASC-US）, 43 cases（0.2%） of atypical squamous cells cannot exclude HSIL（ASC-H）/atypical glandular cells（AGC）, 289 cases（1.3%） of low grade squamous intraepithelial lesions（LSIL）, and 116 cases（0.5%） of high grade squamous intraepithelial lesions（HSIL）. Of these cases with abnormal cytological results, 31 cases（50%） had hr HPV testing positive, and 200 cases（45.6%） had follow-up histological positive. The positive rates of ASC-US（χ^=5.502, P=0.019） and LSIL（χ^=3.956, P=0.047） significantly varied among different age groups. The highest positive rate of ASC-US was found in the 50~59 years old group（197 cases, 3.5%）, while the lowest positive rate was found in the 30~39 years old group（134 cases, 2.6%）. The highest positive rate of LSIL was observed in 30（12 cases） and 30~39（76 cases） years old groups（1.5% for both groups）, while the lowest positive rate was observed in the 50~59 years old group（50 cases, 0.9%）. Histopatholog

关 键 词：宫颈癌 宫颈细胞学 筛查 高危型人乳头状瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]