宫颈癌前病变及宫颈癌筛查方法的研究进展

Screening Methods for Precancerous Lesions and Cervical Cancer

宫颈癌是一个病因明确,可早期预防的恶性肿瘤。肉眼观察法敏感性较低,但在贫困地区有优势。巴氏细胞涂片法因阅片人主观因素及制片技术的原因,导致假阴性率高。薄层液基细胞学检查弥补了巴氏涂片法制片方面的不足。DNA定量分析是宫颈细胞学由传统的描述向定量分析发展的进步,是相较于薄层液基细胞学更为可观的一种筛查方法。人乳头瘤病毒检测技术灵敏度较高,但特异度相对较低,常与细胞学检查联合应用于宫颈癌筛查。阴道镜检查使活检部位更为明确,避免了盲目取材。组织病理学检查是确诊的可靠方法。

Cervical cancer is a malignant tumor with definite cause,and it can be prevented by screening. Visual inspection with acetic acid and Logu＇s iodine is less sensitive but has advantages in poor areas. The Pap smear method is limited by the subjective factors of the readers and the production technology,resulting in a high false negative rate,which can be remedied by the application of thinprep cytology test. DNA ploidy analysis is the progress of cervical cytology from the traditional description to the development of quantitative analysis,which is a more significant screening method than cervical liquid-based cytology. The human papillomavirus testing has a high sensitivity and low specificity and is often adopted to screen cervical cancer together with cytology. Colposcopy makes the biopsy site more clear and avoids the blind draw.Histopathological examination is a most reliable diagnosis.