中国大陆宫颈细胞学筛查技术实施的现状及缺憾

The present situation and defects of cytology screening technique in China mainland

细胞学筛查技术在宫颈病变及宫颈癌的防治中起着举足轻重的作用。从传统的巴氏涂片发展到现今以液基细胞学(liquid-based cytology,LBC)技术为基础的伯塞斯达诊断系统(the bethesda system,TBS),宫颈病变的检出率得到了明显的提高,宫颈癌的死亡率也大大降低。全球宫颈癌总体的发病率与死亡率虽然有所下降,但在欠发达国家和地区,由于资源、技术和人才的缺乏,其发病率与死亡率仍比发达国家高许多,少数地区甚至有上升趋势,以细胞学筛查技术为首的筛查模式遇到了发展的瓶颈期。细胞学筛查作为宫颈病变"三阶梯"筛查模式第一阶梯,仍然起着至关重要的作用。LBC技术是目前最优化的细胞学筛查技术,但TBS技术在中国大陆的应用因细胞病理学医师奇缺,而仍存在"不确定性、不稳定性、不标准性"等缺憾,宫颈病变及宫颈癌的防治工作仍任重道远。本文将综述目前细胞学筛查技术在中国大陆应用现状及局限性,并对该技术未来的发展进行讨论。

Cytological screening plays an important role in the prevention and treatment of cervical lesions and cervical cancer.The application of the technique,which has developed from traditional Papanicolaou（Pap） smear to liquid-based cervical cytology（LBC）,has lead to a significant increase in detectable rate and decrease in death rate from cervical cancer.However,due to lack of technology and resources,although the global morbidity and death rates of cervical cancer have decrease,these two rates are still high in some developing and underdeveloped countries.Cytological screening technique is going through a bottleneck period.Cytological screening technique which is the first-step of the three-step screening model,plays an indispensable role for early detection of cervical cancer and its precursors.LBC is the most optimizing cytological screening technique,but for the lack of doctors of cytopathology as well as the defects of unstability,nondeterminacy and non-standard in Chinese mainland,there is still a long way to go for the prevention and control work for cervical cancer and its precursors.This essay will demonstrate the present situation and defects of cytological screening technique in China mainland.