联苯胺接触人群尿细胞学监护的一些特点

Some characters of the medical surveillance of urine exfoliative cells in the population exposed to benzidine

目的 对上海联苯胺接触人群中医学监护 16年 ( 1983～ 1998年 )作初步总结。方法 监护人群为联苯胺职业接触者 ,采用巴氏分级法作尿脱落细胞检查。巴氏分级为 5级 ,介于相邻两级之间的结果以 0 5表达。受监护 5次以上者列入统计范围 ,采用平均级数和出现过 2 5级以上者的构成比两个指标 ,以t检验和卡方试验进行分析。结果 监护中发生 8例膀胱癌 ,诊断前监护中出现过 2 5级以上者 4例 ( 50 % )。不同工种和不同吸烟情况之间的两指标均无显著差异。女性的平均级数显著高于男性 (t=5 80 4 ,P <0 0 1) ,而出现过 2 5级以上的人数构成比无显著差异。 90年代的两个指标均显著高于 80年代。结论 尿脱落细胞巴氏法仍应作为该人群膀胱癌筛检的一项重要方法 ;规范开展常规医学监护在膀胱癌高危人群的筛检中有重要意义。

Objective To review the medical surveillance data of urine exfoliative cells during 1983～1998 conducted in the population exposed to benzidine in Shanghai.Methods The subjects were workers exposed to benzidine, who had received the medical surveillance for urine exfoliative cells using Papanicoloau's method. The Papanicoloau's grading was described as five grades, and the cells lying between two grades were expressed as 0.5. The subjects having received surveillance for more than 5 times were listed for statistical analysis. Two indexes i.e. average grade and constituent ratio of the subjects with more than grade 2.5 were used, and the analysis was made by t test or Chi square test respectively. Results 8 cases of bladder cancer were found out during the surveillant period and among them, 4 cases (50%) were shown to be more than grade 2.5 during surveillance before diagnosis. No significant difference of two indexes appearted to be seen in different job and different smoking status. The average grade in female was significantly higher than that in male ( t =5 804, P <0 01), but the constituent ratio of the subject with more than grade 2.5 did not show the significant difference. The two indexes in 1990's were significantly higher than that in 1980's.Conclusion Papanicoloau's method of urine exfoliative cells might still serve as an important method for screening bladder cancer in the high risk population. It would be advised to conduct normally the routine medical surveillance for screening bladder cnacer in the high risk population.