宫颈筛查阳性患者的相关危险因素分析  

Risk factors of positive cervical cancer screening

作　　者：麦碧[1] 刘婷艳[1] 胡桂英[1] 何裕[1] 罗喜平[1] Mai Bi;Liu Tingyan;Hu Guiying;He Yu;Luo Xiping(Guangdong Maternal and Child Health Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院妇科

出　　处：《广西医科大学学报》2019年第7期1117-1122,共6页Journal of Guangxi Medical University

基　　金：广东省医学科学技术研究基金资助项目(No.201772123255768)

摘　　要：目的:探讨宫颈筛查阳性患者的相关危险因素。方法:选取2014年1月至2018年8月于广东省妇幼保健院番禺院区收治的宫颈癌(CC)筛查患者10994例,均行宫颈人乳头瘤病毒(HPV)检测,对HPV阳性患者实施薄层液基细胞学(TCT)检查、阴道镜下活体组织检测,统计宫颈阳性病变检出情况,并根据阴道镜检查结果将患者分为宫颈筛查阳性组(n=929)与非阳性组(n=10065),分析宫颈阳性病变发生的影响因素。结果:10994例均接受HPV检测,其中1425例(12.96%)HPV阳性患者接受TCT检查,阴道镜下活检患者中,确诊为宫颈阳性病变929例;宫颈筛查阳性组的年龄、初次性交及初次分娩年龄均低于非阳性组(P<0.05),流产次数、产次、口服避孕药比例、性生活前后未进行清洗比例、有肿瘤相关家族史比例、不知晓宫颈癌比例、不知晓HPV比例、配偶有其他性伴侣比例、配偶外生殖器伴有疾病比例均高于非阳性组(P<0.05);初次性交年龄较早、初次分娩年龄较早、流产次数较多、性生活前后未进行清洗、不知晓宫颈癌、不知晓HPV、配偶有其他性伴侣、配偶外生殖器伴有疾病是发生宫颈阳性病变危险因素(P<0.05)。结论:初次性交年龄较早、初次分娩年龄较早、流产次数较多、性生活前后未进行清洗、不知晓宫颈癌、不知晓HPV、配偶有其他性伴侣、配偶外生殖器伴有疾病的人群是宫颈癌易发人群,这可为临床针对性实施筛查提供参考。Objective: To study the risk factors ofpositive cervical cancer (CC) screening. Methods: From January 2014 to August 2018,10,994 women underwent human papillomavirus (HPV) testing for CC screening in our hospital.The patients with positive results were performed thinprep cytologic test (TCT) and colposcopy-directed biopsy.The influencing factors of cervical positive lesions were analyzed. Results: A total of 1,425 cases (12.96%) received TCT examination,and 929 cases (positive group) were diagnosed as cervical positive lesions by colposcopic biopsy.The age,age of first sexual intercourse and age of first delivery in positive group were lower than those in non-positive group,while the number of abortions,times of delivery,the proportion of oral contraceptives,the proportion of non-cleaning before and after sexual life,and the proportions of family history of cancer,lack of CC or HPV knowledge and spouse having other sexual partners or genital diseases were higher ( P <0.05).Sexual intercourse or first delivery at earlier age,frequent abortion,no cleaning before and after sexual life,lack of CC or HPV knowledge,and spouse having other sexual partners or suffering from genital diseases were the risk factors for cervical positive lesions ( P <0.05). Conclusion: Sexual intercourse or first delivery at earlier age,frequent abortion,no cleaning before and after sexual life,lack of CC or HPV knowledge,and spouse having other sexual partners or suffering from genital diseases were the more likely to develop into CC,and it can provide reference for targeted screening in clinic.

关 键 词：阴道镜 危险因素 宫颈人乳头瘤病毒 薄层液基细胞学检查 诊断效能 

分 类 号：R737.33[医药卫生—肿瘤]