基层实验室宫颈病变筛查方法的改良研究

Study on a New Experimental way Screening for Cervical Lesion for Clinical Use

目的：改良、优化传统巴氏涂片法，探索适合基层实验室宫颈癌病变的筛查方法。方法：健康体检及门诊就医、年龄20～49岁育龄妇女2979名，采用改良的实验室宫颈癌病变筛查方法（简称宫颈病变初筛法）进行筛查，并以巴氏涂片法、阴道镜下活组织病理检查对照验证。结果：用宫颈病变初筛法与传统的巴氏涂片方法，分别对同一标本进行检测。3次检测结果比较均无统计学差异（P〉0．05）；以阴道镜下病理活组织细胞学检测作为金标准，以LSIL／CINⅡ作为阴道镜活检指标，宫颈病变初筛法的灵敏性为80．8％，传统细胞学检查法的灵敏性68．7％，两组比较有显著性差异（P〈0．05）。结论：宫颈病变初筛法提高了巴氏涂片方法筛查的灵敏性，易于掌握，经济实用，适宜基层医疗机构对宫颈病变的初筛。

Objective： To better the traditional papanicolaou test and explore a new experimental way screening for cervical lesion in the primary laboratory. Methods ： The improved laboratory method screening for cervical lesion was conducted and compared with papanicolaou test and colposcopy examination. 2,979 women aged from 29 to 49 were recruited by checkup or from outpatients. Results： There were no statistical significant difference between the improved method and traditional papanicolaou test to screen cervical samples（P 〉 0.05）. These samples were checked three times by each way. The results of colposcopy examination was taken as gold standard. LSIL/CIN Ⅱ was applied as index, the sensitivity of the new method was 80. 8%, And the traditional cytology examination way was 68.7% （P 〈 0.05）. Conclusion： The improved way can increase the sensitivity of papanicolaou test. It is steady, economical, and easy to apply. So it is fit for the clinical use to screen for cervical lesion in primary hospital.