农村欠发达地区宫颈癌筛查方法的探讨  

Investigation on detection of cervical cancer and precancerous lesion by different testings among women in poor rural areas

作　　者：于素香[1] 贾秀镯 王斌[1] 马英兰 YU Su-xiang;JIA Xiu-zhuo;JIA Xiu-zhuo;MA Ying-lan(Department of Pathology,the People′s Hospital of TangXian,Hebei Province,TanXian 072350,China)

机构地区：[1]河北省唐县人民医院病理科,河北唐县072350

出　　处：《河北医科大学学报》2018年第4期450-453,共4页Journal of Hebei Medical University

基　　金：保定市科学技术研究与发展指导计划(17ZF025)

摘　　要：目的探讨保定市唐县区域农村妇女宫颈癌筛查方案,为本地宫颈癌防治提供依据。方法选择2016年5月—2017年5月河北省唐县人民医院妇科门诊就诊妇女中自愿进行机会性筛查者5 587例,分别进行宫颈细胞学检查和(或)高危人乳头瘤病毒(human papilloma virus,HPV)检测以及阴道镜检查、宫颈活组织病理学检查。宫颈细胞学检查采用Thinprep液基薄片的方法,HPV检测应用原位杂交免疫荧光检测系统。结果 1年中共有5 587例门诊就诊妇女进行机会性筛查,年龄18~65岁,平均(38.54±4.43)岁。宫颈细胞学检查宫颈癌及癌前病变的检出率(1.299%)低于高危型HPV检测(3.539%)和联合检测(5.199%),差异有统计学意义(P<0.05)。HPV检测敏感度高于宫颈细胞学检查,低于联合检测,联合检测敏感度最高(P<0.05)。结论联合检测方法宫颈癌及癌前病变的检出率高于细胞学检查和HPV检测,可为临床进一步防治提供参考。但检测方法的选择应结合每例筛查对象的具体情况,因人而异,从而制定出适宜本人的最佳筛查方案。Objective To study the detection plans of cervical cancer by different testings among rural women in Tangxian,Baoding,and to provide treatment reference of cervical cancer for local.Methods The Thinprep cytologic test,Human papilloma virus(HPV)test,colposcopy and biopsy were performed among 5 587 women in outpatient center of gynecologic department from May 2016 to May 2017.Thinprep liquid based cytology was chosen for cytology,In situ hybridization immunofluorescence system applied for hr HPV test.Results A total of 5 587 outpatient visits to women were screened for opportunistic age in a year,aged 18-65 years,average(38.54±4.43)years.The cervical intraepithelial neoplasia 2(CIN2)or greater lesion diagnosed by cotesting(5.199%)was higher than that of hr HPV test(3.539%)and cytology(1.299%)(P<0.05).Differences are statistically significant.The sensitivity of the cotesting was higher than that of hr HPV test and cytology(P<0.05).Conclusion The CIN2 or greater lesions diagnosed by co-testing was higher than that of cytology and hr HPV test.The co-testing could provide more reference for management of abnormal results of cervical screening and very helpful in prevention and treatment.But the testing method should be combined with the specific situation of each patient,and make the best screening program suitable for them.

关 键 词：宫颈肿瘤 农村人口 筛查 

分 类 号：R737.33[医药卫生—肿瘤]