2986例农村妇女宫颈癌筛查结果分析

Results of cervical cancer screening in 2 986 rural women

目的探讨农村妇女宫颈癌发生的危险因素，为宫颈癌的防治提供参考。方法以2014年3月至2014年6月威海市郊区3个乡镇中居住时间超过1年、年龄为35～65岁的农村妇女作为普查对象，均接受妇科内诊检查及液基超薄细胞学（TCT）检查。分析宫颈疾病的发生情况及宫颈糜烂、宫颈息肉、宫颈原位癌发生的危险因素。结果2986例妇女中宫颈异常率为64．9％，35～45岁组的异常率最高，其次为46～55岁组，56—65岁组则最低。1938例宫颈异常的妇女中，81．1％为宫颈糜烂、15．4％为宫颈息肉、0．2％为宫颈原位癌、3．3％为宫颈陈旧裂伤。1938例宫颈异常者的TCT检查结果异常率为2．1％。以ASC—US发生率最高，最低为HISL。宫颈糜烂发生率在35—45岁、已婚人群、经济收入〈1000元、中学及以下、性伴侣数≥2、初次妊娠年龄≤20岁、怀孕次数〉2次、产次〉2次、未定期普查妇女中较高（P〈0．05）。宫颈息肉发生率在35～45岁、已婚和离异、小学及以下学历、经济收入〈1000元、初次性交年龄〈16岁、性伴侣数≥2、初次妊娠年龄≤20岁妇女中较高（P〈0．05）。宫颈原位癌发生率在初次性交年龄〈16岁、性伴侣数≥2的妇女中发生率较高（P〈0．05）。结论对农村妇女加强婚前性知识的宣教及避孕的正确方法，提高其自我保健意识；提倡晚婚、晚育、少育；重视宫颈疾病的筛查，有性生活的妇女、特别是早婚早育、有流产史、性病史、多个性伴侣的妇女应定期普查，必要情况下可行病理活检或阴道镜检查。

Objective To investigate the risk factors of cervical cancer in rural women and to provide reference for the prevention and treatment of cervical cancer. Methods From March to June, 2014, the 35-65 years old rural women who lived in three towns of Weihai suburbs for over one year were selected as investigation objects. All the women received gynecological examination and liquid based cytology （TCT） examination. The occurrence of cervical disease and the risk factors of cervical erosion, cervical polyp, and carcinoma were were analyzed. Results 64.9% of the 2986 women had cervical abnormalities. The cervix abnormal rate was highest in 35-45 years old group, second highest in 46-55 years old group, and lowest in 56-65 years old group. Among the 1938 women with cervical abnormalities, 81.1% were cervical erosion, 15.4% cervical polyps, 0.2% carcinoma in situ, and 3.3% cervical laceration. The abnormal rate of TCT was 2.1% among the 1938 women. The incidence of ASC-US was highest and that of HISL lowest. The incidence of cervical erosion in 35-45 years old, married people, income 〈1000 yuan, middle school and below, the number of sexual partner〉2, initial pregnancy age≤20 years old, pregnant times 〉 2 times, producing time 〉 2 times, or no regular census women were higher （P 〈 0.05）. The incidence of cervical polyp in 35-45 years old, married and divorced, primary and less educated, income 〈 1000 yuan, the age of first sexual intercourse 〈 16 years old, the number of sexual partners 〉 2, or initial pregnancy age 〈 20 women were higher （P 〈 0.05）. The incidence of carcinoma in situ in the women whose first sexual intercourse age 〈16 years old or the number of sexual partners ≥2 was higher. Conclusions The correct method of contraception and education of premarital sexual knowledge should be strengthened in rural women to improve their self health awareness. Late marriage and childbearing and fewer children should be advocated. Attention should be paid on the screening for cervical diseases. Women having sexual life, early marriage or childbearing, abortion history, history of sexually transmitted disease, and multiple sexual partners should have regular census and have pathological biopsy or colposcopy when in need.