宫颈病变机会性筛查体系临床应用研究

Clinical Application of Opportunistic Screening System for Cervical Cancer

目的探讨宫颈癌前病变机会性筛查在门诊患者中的应用及价值。方法对南昌大学第一附属医院2006年1月至2010年6月门诊患者进行机会性筛查(opportunistic screening,OS),筛查方法包括液基细胞学(TCT)、高危型HPV检测,以及液基细胞学检查加高危型HPV-DNA检测,并经阴道镜检查,病理确诊宫颈病变及宫颈癌。结果共收治门诊患者112 692例次,其中接受OS 14 106例次,占门诊例次12.44%。液基细胞学检出宫颈细胞学异常2 219例,占15.83%,诊断为CINⅠ556例,CINⅡ为189例,CINⅢ为72例,宫颈浸润癌为21例。CINⅠ+CINⅡ+CINⅢ+宫颈浸润癌总计838例(5.98%)。结论医院内就诊患者筛查顺从性好,且宫颈病变检出率高,机会性筛查能有效便捷的查出宫颈病变,及时进行规范性治疗,具有较好的社会和经济效益。

Objective To investigate the application and value of opportunistic screening （OS） for cervical cancer and precancerous lesions in outpatients. Methods The OS performed in our hospital from January 2006 to June 2010 was analyzed. Liquid-based cytology testing and HPV- DNA testing were used for OS. Cervical cancer and precancerous lesions were pathologically confirmed by colposcopy and biopsy. Results Among the 112 692 outpatients,14 106（12.44%） received OS. Abnormal cytology results were found in 2 219 cases （15.83%）. Early cervical cancer and precancerous lesions were diagnosed in 838 cases （5.98%）（CIN Ⅰ in 556,CIN Ⅱ in 189,CIN Ⅲ in 72 and cervical infiltration in 21）. Conclusion The OS is an effective,convenient and highly acceptable method with a high detection rate of cervical lesions among outpatients,chich can provide social and economic benefits for timely regulatory treatment of cervical cancer and precancerous lesions.