内蒙古中西部地区宫颈液基细胞学结果分析

Analysis of Cervical Thinprep Liquid Based Cytology Test in Central and Western Inner Mongolia

目的:了解内蒙古中西部地区宫颈癌及宫颈癌前病变的发病情况及流行病学特征。方法:对内蒙古中西部地区66 981例妇女进行薄层液基细胞学技术检测,采用TBS细胞学分类诊断,将诊断意义不明的不典型鳞状上皮细胞(ASCUS)以上病变均列为阳性病例,并进行阴道镜下多点取材活检,以病理学结果为标准,将细胞学检测结果与活检结果作对比分析。分析各年龄组人群宫颈病变的发病规律及蒙汉族妇女宫颈病变的发病趋势。结果:薄层液基细胞学检测(TCT)法标本满意率为99.9%(66911/66981),细胞阳性病例5466例,总检出率8.17%(5466/66911)。检出癌(CA)47例(占0.07%);高度鳞状上皮内病变(HSIL)301例(占0.45%);低度鳞状上皮内病变(LSIL)871例(占1.30%);不除外高度鳞状上皮内病变的不典型鳞状细胞(ASC-H)635例(占0.95%);ASCUS+AGUS共3612例(占5.40%)。取其中5123例与阴道镜下活检结果比较,宫颈癌和癌前病变的病理阳性率和准确率分别是CA(100%,100%);HSIL(97.83%,90.58%);LSIL(93.07%,59.34%);ASC-H(72.79%,40.18%);ASCUS+AGUS(37.69%,37.69%)。经比较蒙古族妇女宫颈病变的发病率高于汉族妇女。不同年龄妇女宫颈病变发病情况有所不同。结论:①TCT技术和TBS系统能较准确地反映宫颈癌和癌前病变。②TCT技术适用于宫颈病变的大规模筛查,3阶梯诊断能明显提高宫颈病变的检出率。③宫颈癌及癌前病变发病率于年龄呈正相关。④内蒙古中西部地区蒙古族妇女宫颈癌及癌前病变患病率高于汉族妇女。⑤筛查是预防和控制宫颈癌的主要手段。

Objective：Through investigating cervical cancer and cervical intraepithelial neoplasia incidence and epidemiologic feature,assess the investigation of the incidence of cervical cancer statistics for the record retrieva of central and western Inner Mongolia.Methods：From erode area 66981 cases of cervical lesions were detected and diagnosed with TCT and TBS.The samples of atypical squamous cells（ASC） and more severe than ASC lesions were classified into positive cases,then multi-cervix tissues were biopsied by colposcope.Compared with pathological examination results of cervical biopsies,analysis the incidence trends of cervical lesions of age group,and summary the incidence law of cervical lesions of the han women and mongolian.Results：The satisfactory rate of TCT samples was 99.9%（66911/66981）and the positive rate of abnormal epithelial cells diagnosed by TCT was 8.17%（5466/66911）.Among the 5466 cases,there were 47 cases（0.07%） of CA,301cases（0.45%） of HSIL,871 cases（1.30%）of LSIL,635 cases（0.95%） of ASC-H and 3612 cases（5.4%） of ASCUS and AGUS.The pathological positive rates of CA,HSIL,LSIL,ASC-H and ASCUS＋AGUS were 100%,97.83%,93.07%,72.79% and 37.39%,respectively.The coincident rate of two examination methods was 100% for CA,90.58% for HSIL,59.34% for LSIL,40.18% for ASC-H and ASCUS＋AGUS for 37.69%.Compare with the Mongolian women and han showed that mongolian women had high incidence of cervical lesions.Different age groups of women have different Incidence of cervical lesions.Conclusion：①TCT and TBS can accurately detect cervical cancer and precancerous lesions.②TCT applies to large scale screening of cervical lesions,three steps diagnosis can obviously elevate the detection rate of cervical lesions.③Premalignant lesion rates and age of cervical cancer were positively correlated.④The morbidity rate of the cervical lesions and precancerous lesions among Mongolia woman are higher than that of han woman.⑤Screening is the main method to prevent and control cervical cancer.