1387例门诊50岁及以上女性宫颈癌机会性筛查结果分析  

Analysis of the results of opportunistic screening for cervical cancer in 1387 outpatients aged 50 and older

作　　者：周扬帆[1] 杨晓扬 李艳 ZHOU Yangfan;YANG Xiaoyang;LI Yan(Department of Pathology,Second People’s Hospital of Guangdong Province/Emergency Hospital of Guangdong Province,Guangzhou 510317,Guangdong,China;Department of Disease Control and Prevention,74th Army Hospital of People’s Liberation Army,Guangzhou 510318,Guangdong,China;Department of Pathology,the Affiliated Hexian Memorial Hospital of Southern Medical University,Guangzhou 511400,Guangdong,China)

机构地区：[1]广东省第二人民医院/广东省应急医院病理科,广州510317 [2]陆军第74集团军医院疾病预防控制科,广州510318 [3]南方医科大学附属何贤纪念医院病理科,广州5114000

出　　处：《癌症进展》2020年第15期1566-1570,共5页Oncology Progress

摘　　要：目的探讨门诊50岁及以上女性宫颈癌机会性筛查的结果。方法选择门诊宫颈癌机会性筛查者13 200例,其中年龄≥50岁1387例,作为观察组;年龄<50岁11 813例,作为对照组。分析两组受检者的宫颈液基细胞学检查结果和高危型人乳头瘤病毒(HR-HPV)检测结果。结果宫颈细胞学检查中,意义不明确的非典型鳞状细胞(ASC-US)及以上为阳性。观察组的宫颈细胞学筛查阳性率为25.16%(349/1387),明显高于对照组的12.54%(1481/11 813),差异有统计学意义(P<0.01)。观察组中,60~64岁受检者的细胞学筛查阳性率最高(达31.41%),≥65岁受检者的细胞学筛查阳性率最低(18.70%)。各年龄阶段受检者的细胞学筛查阳性率比较,差异有统计学意义(P<0.01)。观察组的HR-HPV感染率为17.26%,明显高于对照组的13.53%,差异有统计学意义(P<0.01)。不同年龄阶段受检者的HR-HPV感染情况比较,差异有统计学意义(P<0.01)。观察组中,细胞学筛查阳性患者的HR-HPV感染率达60.47%,明显高于细胞学筛查阴性患者的4.21%(P<0.01)。结论 50岁及以上女性具有较高的宫颈细胞学筛查阳性率及HR-HPV感染率,机会性筛查能够尽早发现宫颈病变,降低宫颈癌的发生风险,而宫颈液基细胞学检查联合HR-HPV检测能够提高筛查的灵敏度和特异度。Objective To analyze the results of opportunistic screening for cervical cancer in outpatients aged 50 and older.Method The data of 13 200 outpatients who under opportunistic screening for cervical cancer were analyzed.There were 1387 cases in study group aged 50 years and older,and the remaining 11 813 cases aged<50 years old were included as control group.The cervical liquid-based cytology and high-risk human papillomavirus(HR-HPV)detection results were assessed and compared between the two groups.Result In liquid-based cytology testing,positivity was defined as atypical squamous cells of undetermined significance(ASC-US) and above.The positive rate of cervical cytology screening in study group was 25.16%(349/1387),which was significantly higher compared to the12.54%(1481/11 813) in control group(P<0.01).Among participants in study group aged 60-64 years,the positive rate of cytology screening was the highest as 31.41%,while in those aged≥65 years,the positive rate was the lowest at18.70%.There was significant difference in the positive rate of cervical cytology screening among different age(P<0.01).The overall infection rate of HR-HPV in the study group was 17.26%,and it was evidently higher than the 13.53% in control group(P<0.01).Significant difference was observed for the HR-HPV infection rate among different age(P<0.01).In the study group,it was noted that the infection rate of HR-HPV in participants with positive cytology screening results was as high as 60.47%,which was markedly higher compared to 4.21% in those with negative cytology screening results(P<0.01).Conclusion The cervical cytology screening and HR-HPV detection yields relatively higher positive rates in patients aged 50 and older,opportunistic screening allows the early detection of cervical lesions,thus lowering the risk of developing cervical cancer,while the cervical liquid-based cytology combined with HR-HPV detection may improve the sensitivity and specificity of screening.

关 键 词：宫颈液基细胞学 高危型人乳头瘤病毒 机会性筛查 

分 类 号：R737.33[医药卫生—肿瘤]