HP V初筛联合TCT分流在昆明市农村地区女性宫颈癌筛查中的应用  

Effectiveness of HPV and TCT Technology in the Screening of Cervical Smears for Women in Rural Areas of Kunming

作　　者：刘双玥[1] 储丽萍[1] 邓继红[1] 谭露[1] 安红梅[1] 张雯[1] LIU Shuang-yue;CHU Li-ping;DENG Ji-hong;TAN Lu;AN Hong-mei;ZHANG Wen(Dept.of Gynecology,Kunming Maternity and Child Care Hospital,Kunming Yunnan 650031,China)

机构地区：[1]昆明市妇幼保健院妇科门诊,云南昆明650031

出　　处：《昆明医科大学学报》2018年第11期79-82,共4页Journal of Kunming Medical University

基　　金：云南省科技计划项目(2017FD049);昆明市卫生科技人才培养暨技术中心建设项目[SW(技)-49]

摘　　要：目的评价在云南省昆明市农村地区女性宫颈癌筛查中运用人乳头瘤病毒(human papillomavirus,HPV)检查初筛联合新柏氏液基细胞学(TCT)分流的应用价值。方法对云南省昆明市农村地区35～64岁女性在2017年1月1日至12月31日之间进行的宫颈癌筛查中,应用HPV初筛联合TCT分流,阳性者转诊阴道镜检查。对阴道镜下检查异常或不满意处取病理活检。结果筛查39 313例,HPV高危型阳性率为6.9%,TCT检测阳性率为14.8%。活检总数285例,宫颈癌前病变及宫颈癌阳性检出率0.22%,其中CIN1:26例,CIN2:28例,CIN3:27例,宫颈息肉19例,宫颈尖锐湿疣2例,宫颈癌6例。结论 HPV初筛联合TCT检测能够明确降低阴道镜转诊率,提高宫颈疾病检出率,是对农村地区适龄妇女开展宫颈癌筛查的有效方法,值得推广。Objective To evaluate the effectiveness of human papillomavirus detection technology in thescreening of cervical smears for women in rural areas of Kunming, Yunnan Province, and provide evidence for theevaluation and optimization of national cervical cancer screening programs.Method In 2017, women aged35-64 years were screened for cervical cancer using HPV testing in women in the rural area. The positive patientswere treated with Tsb-based cytology （TCT ） and positive patients were switched to colposcopy. A biopsy wasperformed with abnormal or unsatisfactory colposcopy. Pathological findings were for moderate cervical intraepithelialneoplasia and referral for surgical treatment.Results Among the 39313 cases that participated in the screening,the infection rate of HPV high-risk type was 6.9%,and the positive rate of TCT detection was 14.8%. The totalnumber of biopsy patients was 285. The positive rate of cervical precancerous lesions and cervical cancer was 0.22%.Among them,26 were CIN 1：26,28 were CIN 2：27,27 were CIN3,19 were cervical polyps,2 were cervicalcondyloma, and 6 were cervical cancer.Conclusion HPV primary screening and TCT detection strategies canreduce the referral rate of colposcopy and the detection rate of cervical disease is high. This method can be used inconditional rural areas. HPV testing is the preferred primary screening method for cervical cancer. In resource-poorareas, training primary-level doctors to use TCT to perform cervical cancer screening for women of the right age isan effective alternative.

关 键 词：宫颈癌 HPV初筛 新柏氏液基细胞学 

分 类 号：R737.33[医药卫生—肿瘤]