中山地区大规模宫颈癌筛查TCT结果及易感因素分析

Analysis on the results of TCT and predisposing factors of large-scale cervical cancer screening in Zhonshan region

目的探讨中山地区宫颈癌及癌前病变筛查TCT结果和流行病学情况。方法 2011年3月-2013年12月对中山市130 475例已婚妇女采用液基薄层细胞学(TCT)和新柏氏电脑辅助阅片系统(TIS)进行检测,将ASCUS/AGC以上病变列为TCT阳性病例并进行阴道镜下多点活检作进一步确诊,并对其危险因素进行分析。结果 TCT总阳性率4.29%,宫颈癌检出率为38/10万(50/130 475)。单因素分析结果显示:筛查者的年龄、初次性生活年龄、文化程度、职业、绝经、工具避孕等因素与TCT阳性率有关;多因素分析结果显示:年龄、文化程度、职业和绝经差异仍然有统计学意义(P<0.05),提示其为TCT阳性率的独立影响因素。结论中山地区宫颈癌发生率较高,年龄、文化程度、职业、绝经、工具避孕等因素与TCT阳性率有关,对当地妇女进行个人健康教育及宫颈癌防治知识宣传是预防宫颈癌和癌前病变的重要措施和保障。

Objective To explore the results of thinprep cytology test （TCT） and epidemiological situations in cervical cancer and cancer precancerous lesion in Zhonshan region. Methods From March 2011 to December 2013, 130 475 married women in Zhonshan city were screened with TCT and thinPrep imaging system （TIS） . The cases with ASCUS/AGC and above were postive eases, then they were further diagnosed by cotposcopical mutiple biospies, the risk factors were analyzed. Results The total postive rate of TCT was 4. 29%. The detection rate of cervical cancer was 38 per 100 thousand cases （50/130 475） . Univariate analysis results showed that age, age of sexual life for the first time, educational level, profession, menopause, and contraception by tools were related to positive rate of TCT; mutlivariate analysis showed that there were statistically significant differences in age, educational level, profession, and menopause （ P〈0. 05 ）, which indicated that they were independent influencing factors of postive rate of TCT. Conclusion The incidence rate of cervical cancer in Zhons- han region is high. Age, educational level, profession, menopause, and contraception by tools are elated to positive rate of TCT. Personal health education and cervical cancer prevention and control knowledge propaganda are important measures and guarantee for preventing cervi- cal cancer and cervical precancerous lesion among the local women.