人乳头瘤病毒联合液基薄层细胞学筛查宫颈癌及癌前病变的结果分析

Analysis of screening results of cervical cancer and precancerous lesions by HPV combined with TCT

目的通过分析广西4个县区的宫颈癌筛查情况,探索宫颈癌的防治策略。方法对广西20 005名农村妇女进行妇科检查和人乳头瘤病毒(HPV)初筛,对HPV高危型和高危亚型者进行宫颈细胞学检查,对HPV高危分型检测结果为16或18型、宫颈细胞学检查结果异常/可疑者以及肉眼检查异常者进行阴道镜检查,阴道镜异常/可疑者进行病理检查。结果检出宫颈癌前病变55例(275/10万)、宫颈癌8例(40/10万),癌前病变在45~54岁发病率最高,宫颈癌在55~64岁发病率最高,文化程度越低宫颈癌发病率越高,宫颈癌和癌前病变主要发生在其他少数民族中。结论液基薄层细胞学检测技术(TCT)联合HPV的筛查方法,能更有效地筛查出宫颈癌患者,同时应积极治疗女性生殖道感染,且有针对性地加强农村及偏远地区妇女,特别是少数民族妇女的健康教育工作,使更多妇女定期接受妇科检查和宫颈癌筛查,保障妇女的生殖健康。

Objective To explore the prevention and treatment strategy of cervical cancer by analyzing the screening of cervical cancer in 4 counties of Guangxi. Methods Gynecological examination and screening of human papilloma virus （HPV）were carried out in 20 005 rural women in Guangxi.Cervical cytology tests were performed for high risk and high risk subtypes of HPV.Vaginoscopy was performed in women with the following situations women with the high risk typing of HPV was 16 and 18,women with abnormal/suspicious cytologic findings of cervical cytology, and women with abnormal condition by macrography.And women with abnormal/suspicious findings by vaginoscopy were given further pathological examination. Results Cervical precancerous lesions were found in 55 cases（275/100 000） , and cervical cancers were found in 8 cases （40/100 000）.The lower the level of education, the higher the incidence of cervical cancer,and cervical cancer and precan-cerous lesions were mainly among other ethnic minorities. Conclusion TCT combined with HPV screening can more effec-tively screen cervical cancer patients.At the same time,female reproductive tract infections should be actively treated,and tar-geted efforts should be made to strengthen the health education of women（ especially minority women） in rural and remote are- as.In addition, regular gynecology and cervical cancer screening should be provided to more women to protect their reproduc-tive health.