内蒙古镶黄旗地区妇女宫颈病变筛查现状

Status of cervical lesion screening of women living in Xianghuangqi of Neimenggu province

目的探讨宫颈细胞学(包括巴式涂片及超柏氏薄层液基细胞学)及阴道镜检查筛查内蒙古镶黄旗地区妇女宫颈病变的现状及临床意义。方法2004年7月至2009年1月对内蒙古镶黄旗地区的642例28～67岁有性生活妇女进行宫颈病变筛查,其中557例妇女行传统宫颈巴式涂片法,85例妇女行宫颈超柏氏薄层液基细胞学,并对宫颈细胞学异常者(≥ASCUS)行阴道镜检查及活检。结果642例妇女中宫颈细胞学阳性(≥ASCUS)者34例,占5.3%(34/642),其中ASCUS者22例,占64.7%(22/34);低度鳞状上皮内病变(LSIL)者6例,占17.6%(6/34);高度鳞状上皮内病变(HSIL)者6例,占17.6%(6/34),其中有1例肯定为宫颈癌。宫颈细胞学阴性608例,占94.7%(608/642)。宫颈细胞学阳性34例人群中,行阴道镜活检病理检查者有25例,其中慢性宫颈炎13例(52.0%);CIN1为5例(20.0%);CIN2为4例(16.0%);CIN3为1例(4.0%);浸润癌为2例(8.0%)。结论应重视并及时进行经济不发达地区妇女人群宫颈病变的早期筛查,传统宫颈巴式涂片法及阴道镜活检及病理学检查为可行的筛查方法,有条件者可进行宫颈薄层液基细胞学结合阴道镜活检及病理学检查,对提高早期宫颈癌筛查的准确性效果明显。对内蒙古等西部地区,应在完善技术力量支持、筛查质量控制、建立筛查后的转诊制度及治疗的绿色通道等方面,以降低宫颈癌的发病率。

Objective To analysis the value of cytology and colposcopy in cervical lesion screening of women living in Xianghuangqi of Neimenggu province.Methods A total of 642 women at their 28～67 age who living in Xianghuangqi of Neimenggu province were screened for cervical lesion. Among them, 557 women were sampled cervical papsmear and the other 85 women were sampled cervical cytology （LCT）. Colposcopy and biopsy were conducted in women with positive cytology. Results Among the 642 women, the positive rate of cytology （≥ASCUS） was 5.3% （34/642）. Except 9 women who refused to take colposcopy, among the other 25 women with positive cervical cytology, 2 invasive cervical cancer, 1 CIN3, 4 CIN2 and 5 CIN1 were found out.Conclusions We should pay more attention to cervical lesion screening of people living in poor health condition area.Combined analysis of cytology and colposcopy provides very helpful information for the screening of cervical lesion.