乌审旗3000名妇女宫颈癌筛查结果分析

Wushenqi 3 000 Analysis of Cervical Cancer Screening of Women

目的：了解乌审旗妇女宫颈癌及癌前病变的发病现状,探讨子宫颈液基细胞学（Thinprep paptest,TCT）结合阴道镜检查的诊断价值。方法：对3 000名乌审旗妇女进行TCT筛查,对TCT阳性（细胞学TBS分类为不典型鳞状细胞以上）的妇女进行阴道镜及镜下多点活组织检查（活检）,分析TCT阳性者的阴道镜检查及活检结果,比较TCT阳性者中不同年龄段患者的活检结果。结果：3 000名受检者中,TCT阳性537例（17.9%）,其中经活检证实为宫颈上皮内瘤变（cervical intraepthelial neoplasia,CIN）190例（6.3%）,宫颈浸润癌2例（0.07%）,537例TCT阳性者中,阴道镜检查正常264例（49.2%）,其中活检结果为CIN34例,阴道镜的假阴性率为12.9%,异常273例（50.8%）,其中活检结果为湿疣34例,CIN或浸润癌158例,阴道镜与活检的诊断符合率达70.3%（192/273）。TCT为轻度鳞状上皮内病变、高度鳞状上皮内病变、鳞状细胞癌的病例与活检的诊断符合率分别为50.4%,88.3%和2/2,假阳性率则分别为49.6%、11%和0。537例TCT阳性者中,2030岁组、3140岁组,4147岁组的CIN检出率分别为33.7%、44.5%2、6.7%（P〈0.05）。结论：乌审旗妇女CIN的发生率高,是宫颈癌的高发人群。TCT结合阴道镜检查是较好的宫颈癌筛查手段之一。

Objective：To understand the Wushenqi women the incidence of cervical cancer and precancerous lesions the status quo,explore the liquid-based cervical cytology（Thinprep pap test,TCT） with the diagnostic value of colposcopy.Methods： 3 000 Wushenqi TCT women screened positive for TCT（TBS cytology classified as a typical squamous cells or more） of women with colposcopy and biopsy microscopic multi-point（biopsy）,analysis of TCT-positive who colposcopy and biopsy results,compared TCT-positive patients of different ages biopsy results.Results： 3 000 subjects who,TCT positive for 537 cases（17.9%）,which confirmed by biopsy of cervical intraepithelial neoplasia（cervical intraepthelial neoplasia,CIN） 190 cases（6.3%）,cervical carcinoma in 2 cases（0.07 %）,537 cases of TCT-positive persons,264 cases of normal colposcopy（49.2%）,in which biopsy results CIN 34 cases of false-negative rate of colposcopy was 12.9%,abnormal 273 cases（50.8%）,in which biopsy results 34 cases of condyloma,CIN or invasive carcinoma 158 cases,colposcopy and biopsy diagnostic rate of 70.3%（192 / 273）.TCT mild squamous intraepithelial lesion,high-grade squamous intraepithelial lesion,squamous cell carcinoma patients with biopsy diagnosis consistent with rates of 50.4%,88.3% and 2 / 2,false-positive rates were 49.6 %,11% and 0.537 cases of TCT-positive persons,20 to 30 age group,31 to 40 age group,41 to 47 age group of CIN detection rates were 33.7%,44.5%,26.7%（P〈0.05）.Conclusion： The incidence of CIN Wushenqi women is high.TCT combination of colposcopy is a better means of screening for cervical cancer.