2019年和2020年新疆石河子城区宫颈癌筛查结果对比研究  

Comparative Analysis of Cervical Cancer Screening Results in 2019 and 2020 in Shihezi Urban Areas,Xinjiang

作　　者：刘玉 韦艳 杨萍[1] LIU Yu;WEI Yan;YANG Ping(Department of Gynecology,First Affiliated Hospital,School of Medicine,Shihezi University/National Health Commission Key Laboratory of Prevention and Treatment of High Incidence Diseases in Central Asia,Shihezi 832008,China)

机构地区：[1]石河子大学医学院第一附属医院妇科,国家卫生健康委中亚高发病防治重点实验室,新疆维吾尔自治区石河子市832008

出　　处：《中国全科医学》2022年第18期2223-2230,共8页Chinese General Practice

基　　金：国家自然科学基金面上项目(82072893);石河子大学成果转化与技术推广计划(CGZH201701);中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助(2020-PT330-003);兵团科技攻关项目(2017DB012)。

摘　　要：背景由于我国各地经济、文化发展水平参差不齐,宫颈癌防控实施效果也不尽相同,而了解各地宫颈癌筛查结果对制订有效的防治策略意义重大。目的对比2019年和2020年新疆石河子城区宫颈癌筛查结果,了解本地区妇女人乳头瘤病毒(HPV)感染及宫颈病变检出率的变化情况。方法回顾性收集2018年12月至2020年6月在新疆石河子市妇幼保健院、石河子市人民医院和石河子大学医学院第一附属医院以HPV为初筛的46994例石河子城区妇女的宫颈癌筛查数据。2019年已行宫颈癌筛查妇女,2020年不再进行宫颈癌筛查。数据包括2019年和2020年HPV感染率及其亚型分布、薄层液基细胞学检测(TCT)及阴道镜宫颈组织活检病理诊断结果,并进行分析比较。结果2019年行宫颈癌筛查的妇女18378例,2020年28616例;最终完成宫颈癌筛查的妇女44746例,2020年宫颈癌筛查完成率97.07%(27779/28616)高于2019年92.32%(16967/18378)(P<0.05)。2019年和2020年共检出HPV阳性5992例(12.75%)。在HPV阳性人群中,HPV 16、18型阳性者占18.55%(1112/5992),其他亚型阳性者占81.45%(4880/5992)。2020年宫颈癌筛查HPV阳性率〔11.09%(3176/28616)〕低于2019年〔15.32%(2816/18378)〕(P<0.05)。2019年、2020年宫颈癌筛查HPV单一类型阳性率分别为11.38%(2092/18378)、7.45%(2674/28616),多种类型阳性率为3.94%(724/18378)、1.75%(502/28616);2020年宫颈癌筛查HPV单一类型阳性率、多种类型阳性率均低于2019年(P<0.05)。2年30~39、40~49、50~59、60~65岁宫颈癌筛查妇女HPV阳性率依次为10.37%(909/8767)、12.22%(1916/15677)、13.71%(2500/18234)、15.45%(667/4316),HPV阳性率随年龄增高而增加(P<0.05)。相较于2019年,2020年30~39、40~49、50~59、60~65岁宫颈癌筛查妇女HPV阳性率均有下降(P<0.05)。2019年单一高危型HPV感染类型前5位依次为HPV 52型(20.84%)、HPV 16型(14.48%)、HPV 53型(8.56%)、HPV 51型(7.93%)和HPV 39型(7.60%)/HPV 68型(7.60%),2020年为HPV 5Background The results of cervical cancer containment have demonstrated regional differences in China,which may be due to various socioeconomic and cultural developments across regions.Understanding cervical cancer screening results in various regions is of a great significance for developing effective cervical cancer prevention strategies.Objective To perform a comparative analysis of the results of two yearly cervical cancer screening(2019 and 2020)in urban areas of Shihezi,Xinjiang,to estimate the changes in high-risk human papillomavirus(hrHPV)infection and cervical lesion detection rate in women.Methods A retrospective design was used.Participants were 46994 women from Shihezi urban areas who underwent initial cervical cancer screening with an HPV test〔underwent once either between December 2018 and December 2019(the 2019 yearly screening)or between January and June 2020(the 2020 yearly screening)〕in Shihezi Maternal and Child Health Hospital,Shihezi People’s Hospital,and First Affiliated Hospital,School of Medicine,Shihezi University during December 2018 to June 2020.Data of the screening results,including HPV infection rate and subtypes,Thinprep cytologic test results,and pathological diagnosis of cervical biopsy samples taken during a colposcopy were collected,and those of the 2019 yearly screening were compared with those of 2020 yearly screening.Results There were 18378,and 28616 attendees for 2019,and 2020 yearly screenings,respectively,and 44746 of them finally completed the screening.The completion rate of cervical cancer screening in 2020 was higher than that in 2019〔97.07%(27779/28616)vs(16967/18378)〕(P<0.05).A total of 5992 cases(12.75%)were detected with HPV infection,among them,the prevalence of HPV 16 and HPV 18 was 18.55%(1112/5992),and that of other HPV subtypes was 81.45%(4880/5992).The prevalence of HPV infections in participants of 2020 yearly screening〔11.09%(3176/28616)〕was lower than that in participants of 2019 yearly screening〔15.32%(2816/18378)〕(P<0.05).The prevalen

关 键 词：宫颈肿瘤 筛查 人乳头瘤病毒 阴道镜检查 年龄分布 妇女卫生保健服务 

分 类 号：R737.33[医药卫生—肿瘤]