济南市章丘区2020年农村妇女宫颈癌筛查结果分析

Analysis of cervical cancer screening results of rural women in Zhangqiu District,Jinan City in 2020

目的分析2020年章丘区进行宫颈癌筛查的35~64岁农村妇女的检查结果,以了解农村妇女宫颈癌筛查的成效。方法选取16392例行免费“两癌”筛查的章丘区35~64岁农村妇女,采用宫颈液基薄层细胞学检查(TCT)进行初筛。对TCT可疑阳性、阳性或妇科检查肉眼可见的宫颈肿块、溃疡者行阴道镜检查及宫颈活检,必要时行宫颈管搔刮,然后进行组织病理学诊断。结果2020年,共完成宫颈癌筛查16392例。其中宫颈TCT检查阳性(ASC-US及以上)487例,阳性率为2.97%。TCT阳性患者行阴道镜检查476例,宫颈癌随访管理率为97.74%;阴道镜检查异常可疑234例,均行病理检查。其中确诊宫颈病变64例。其中宫颈低级别病变16例,高级别病变(癌前病变)47例(包括宫颈原位癌1例,检出率为287/10万),微小浸润癌1例,检出率为6.1/10万,宫颈癌早诊率为100%。宫颈病变在45~54岁年龄段多见,构成比为53.19%。结论章丘区宫颈癌筛查取得了一定的成效。在今后的工作中,仍需重视和加强章丘区TCT筛查技术水平,通过加强质控、检测人员技术培训、定期进行质量控制和考核等手段,提高宫颈细胞学检测水平,降低误诊率和漏诊率。

Objective To analyze the results of cervical cancer screening in rural women aged 35~64 in Zhangqiu District in 2020,so as to understand the effectiveness of cervical cancer screening in rural women.Methods 16392 rural women aged 35~64 years old in Zhangqiu District were selected for free screening of"two cancers',and the cervical liquid base thin layer cytology(TCT)was used for preliminary screening.Colposcopy and cervical biopsy were performed for cervical lumps and ulcers that were suspected to be positive on TCT,positive or visible in gynecological examination.If necessary,cervical tube scratching was performed,and then histopathological diagnosis was made.Results In 2020,a total of 16392 cases of cervical cancer screening were completed.Among them,487 cases were positive by TCT(ASC-US and above),the positive rate was 2.97%.Colposcopy was performed on 476 TCT positive patients,and the follow-up management rate of cervical cancer was 97.74%.Pathological examination was performed in 234 cases with abnormal colposcopy.Among them,64 cases were diagnosed with cervical lesions.Among them,there were 16 cases of low-grade cervical lesions,47 cases of high-grade cervical lesions(precancerous lesions)(including 1 case of cervical carcinoma in situ,the detection rate was 287/100,000),1 case of microinvasive cancer,the detection rate was 6.1/100,000,and the early detection rate of cervical cancer was 100%.Cervical lesions were most common in 45~54 years of age,with a composition ratio of 53.19%.Conclusion Cervical cancer screening in Zhangqiu district has achieved certain results.In the future work,it is still necessary to pay attention to and strengthen the level of TCT screening technology in Zhangqiu District,improve the level of cervical cytology detection by strengthening quality control,technical training of detection personnel,regular quality control and assessment,and reduce the rate of misdiagnosis and missed diagnosis.