不同筛查方法预警宫颈原位腺癌的效能  

Early warning efficiency of different screening methods on cervical adenocarcinoma in situ

作　　者：石皆春 范子玉 邢燕[1] Jiechun Shi;Ziyu Fan;Yan Xing(Department of Gynecology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu Province,China)

机构地区：[1]南京医科大学第一附属医院妇科,南京210029

出　　处：《中华妇幼临床医学杂志（电子版）》2024年第5期575-581,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：江苏省卫健委卫生发展研究中心公开基金资助项目(JSHD2022024);江苏省妇幼健康研究会资助项目(JSFY202108)。

摘　　要：宫颈原位腺癌(AIS)为宫颈腺癌(CA)的癌前病变,进展为浸润癌的风险高。由于宫颈AIS临床表现不典型、病灶隐匿,对宫颈癌的现有筛查方法不敏感,因此临床对宫颈AIS患者的早期发现及诊断存在一定困难和挑战。目前,国内外普遍采用宫颈脱落细胞学检查,即宫颈液基薄层细胞学检测(TCT)联合高危型人乳头状瘤病毒(HPV)初筛+阴道镜检查+组织病理学检查的“3阶梯”宫颈病变诊断模式,其中宫颈TCT联合高危型HPV初筛逐渐过渡为高危型HPV初筛。一些宫颈癌筛查新技术,如宫颈脱落细胞DNA倍体分析、p16/Ki-67双染也逐渐被应用于临床。随着医工融合领域兴起,计算机辅助诊断和图像识别技术在宫颈癌筛查中的应用,也在进一步研究发展中。笔者拟就不同筛查方法预警宫颈AIS效能的最新研究现状进行阐述。Cervical adenocarcinoma insitu(AIS),as a precancerous lesion of cervical adenocarcinoma(CA),has a high risk of progressing to invasive cancer.Due to the atypical clinical manifestations,insidious lesions and the insensitivity of existing cervical cancer screening methods,there are certain difficulties and challenges in the early detection and diagnosis of AIS.At present,the"3-step"cervical lesion diagnosis ThinPrep liquid-based cytology test(TCT)combined with high-risk human papillomavirus(HPV)preliminary screening+colposcopy+histopathology is generally adopted at home and abroad,in which TCT combined with high-risk HPV preliminary screening gradually transitions to high-risk HPV preliminary screening.Some new techniques of cervical cancer screening,such as DNA ploidy a nalysis and p16/Ki-67 double staining of cervical exfoliated cells,have been gradually applied in clinical practice.With the rise of medical and industrial integration,the application of computer-aided diagnosis and image recognition technology in cervical cancer screening is also being further studied and developed.This article elaborates on the latest research status on early warning efficacy of different screening methods on cervical AIS.

关 键 词：腺癌 原位宫颈肿瘤 宫颈非典型增生 细胞学技术 人乳头瘤病毒 高危型 宫颈液基薄层细胞学检测 阴道镜检查 女(雌)性 

分 类 号：R737.33[医药卫生—肿瘤]