泰安市宫颈癌筛查情况分析

Analysis on cervical cancer screening in Taian

目的对泰安市宫颈癌筛查情况进行分析，为探讨适宜宫颈癌的筛查模式提供参考。方法2010年10月对泰安市岱岳区所辖乡镇6830名已婚妇女开展宫颈癌筛查。采用专用宫颈刷收集宫颈及颈管脱落细胞，放入盛有专用保存液的标本瓶中，制成薄层细胞涂片，进行FeulgenDNA染色做DNA定量测定，由全自动DNA倍体定量分析系统进行扫描。用DNA指数（DNAindex，DI）代表细胞核的DNA含量，DI〉2．5为异常细胞，异常细胞称为异倍体细胞。如检查未见异倍体细胞，建议按常规定期筛查；见1-2个异倍体细胞或细胞增殖比例5％-10％，建议4-6个月复查；≥3个异倍体细胞或者细胞增殖比例），10％，均建议行阴道镜检查、宫颈组织活检。组织学病理诊断包括：（1）正常或炎症；（2）宫颈上皮内瘤变（cervicMintraepitheliMneoplasia，CIN）：分为CINI、CINⅡ、CINⅢ及原位癌；（3）浸润癌。数据输入Excel2003，进行描述性分析。结果6830名已婚妇女中异倍体细胞检出率8．39％，1-2个检出率5．81％，≥3个检出率2．58％。阴道镜下活检，CINⅡ及以上病变51例，患病率为0．75％。原位癌患病率为0．04％，浸润癌患病率为0．03％。30~45岁CIN和宫颈癌高发，其中30。35岁、35～40岁、40～45岁CINI、CINⅡ、CINm、原位癌、浸润癌患病率分别为1．84％、0．70％、0．61％、0．09％、0．09％．1．23％、0．65％、0．39％、0．06％、0，0．82％、0．16％、0．25％、0．08％、0。结论全自动DNA倍体定量分析系统可以作为宫颈癌可靠方法，同时加强宣传、提高筛查覆盖率、规范宫颈病变的早诊早治技术，可降低宫颈癌的患病率和病死率。

Objective An analysis was carried out on the data of cervical cancer screening in Taian city to explore a suitable model of cervical cancer screening.Methods A total of 6 830 married women from Daiyue district of Taian city received cervical cancer screening in October 2010.Special cervical brushes were used to collect exfoliated cells of the cervix and cervical canal, / which were placed in specimen bottle with special preserve fluid and then made into thin-layer cell smear that received feulgen DNA staining for the quantitative determination of DNA,whieh was scanned by automatic DNA ploidy analysis system.DNA index （DI） was used to represent cellular DNA content, and DI〉2.5 indicated the presence of abnormal cells,also called aneuploid cells.If there was no aneuploid cells,regular screening was recommended; if there were l-2 aneuploid cells or cell proliferation ratio ranged between 5%-10%,a follow-up was recommended 4-6 months later; ff the number of aneuploid ceils was 〉/3 or cell pro- liferation ratio was /〉 10%,colposcopy and cervical biopsy were recommended.The histopathological diagnosis included （1） normal or inflammatory condition;（2） cervical intraepithelial neoplasia（CIN）：CIN I ,CIN ]I ,CIN m （classified according to disease severity） and carcinoma in situ;（3） invasive carcinoma.The data obtained was typed into Excel 2003 for a descriptive analysis.Results Ane- uploid cells were detected in 6830 cases,accounting for 8.39%,of which,5.81% were found to have 1-2 aneuploid cells,and 2.58% were found to have 〉1 3 aneupl0id cells.Fifty-one cases were diagnosed as CIN II or CIN III with colposcopy and the incidence was 0.75%.The incidence of carcinoma in situ and invasive cancer was 0.04% and 0.03% respectively.For women aged 30-45 years,there was a higher incidence of ＇CIN and cervical cancer, of which,the incidence of CIN I ,CIN 11 ,CIN m ,carcinoma in situ and invasive cancer was 1.84%,0.70%,0.61%,0.09% and 0.09% respectively in women aged 30-35 years,and 1.23%,0.65%, 0.39%,0.06%,0 and 0.82% respectively in women aged 35-40 years,and 0.16%,0.25%,0.08% and 0 respectively in women aged 40-45 years.Conclusion Automatic DNA ploidy analysis system can be used as a means of cervical cancer screening,at the same time,strengthening publicity,improving screening coverage,specifying the technology for early diagnosis and treatment of cer- vical lesions can reduce the incidence and mortality of cervical cancer.