631例宫颈癌筛查结果分析

The analysis of 631 cases cervical cancer screening

目的了解本地区宫颈癌筛查情况,为更好防治宫颈癌提供参考。方法回顾性分析2017年7月1日~11月1日在昆山妇幼保健所参加两癌筛查的631例妇女宫颈癌筛查资料。结果 631例妇女中,年龄30~35岁8例(1.3%),35~64岁623例(98.7%)。从未做过宫颈癌筛查者271例(43%),做过宫颈癌筛查者360例(57%)。初筛结果未见异常260例(41.2%),异常371例(58.8%),其中滴虫性阴道炎4例,霉菌性阴道炎19例,细菌性阴道病13例,子宫肌瘤9例,宫颈炎242例,其他84例。宫颈脱落细胞检查(液基细胞学检查,TCT)异常22例(3.5%),其中无明确诊断意义的非典型鳞状上皮(ASCUS)17例,低度鳞状上皮内病变(LSIL)3例,高度鳞状上皮内病变(HSIL)2例。组织病理检查22例(3.5%),其中4例宫颈息肉,2例宫颈炎,8例见挖空细胞,3例低级别病变,4例高级别病变,1例宫颈浸润鳞癌。TCT检查结果随TBS分类级别升高,宫颈高级别以上病变的可能增大(P<0.05),HPV阳性的人群宫颈高级别以上病变的发生率高于HPV阴性的人群,差异有统计学意义(P<0.05)。结论宫颈癌筛查对宫颈癌及癌前病变的早发现以及高危人群的识别有重要价值。

Objective To investigate cervical cancer screening in Kunshan, and provide reference for better prevention and treatment of cervical cancer. Methods Analysized retrospectively the clinical datas of 631 women who received screening cervical cancer and breast cancer from July 1 to November 1 in 2017 in Kunshan Maternal and Child Care Institute. Results Of 631 cases, 8 cases（1.3%） aged 30~35, 64 cases（98.7%） aged 35~64. 271 cases（43%） had never participated in screening cervical cancer before, 360 cases（57%） had participated in cervical cancer screening. 260 cases（41.2%） were normal, 371 cases（58.8%） were abnormal, including 4 cases trichomonasvaginalis, 19 cases vulvoaginalcandidasis, 13 cases bacterial vaginosis, 9 cases uterine fibroid, 242 cases cervicitis, 84 cases others. Thinprep cytology test（TCT） of 22 cases（3.5%） were abnormal, among them 17 cases were ASCUS, 3 cases were LSIL, 2 cases were HSIL. 22 cases（3.5%） had histopathologic result, including 4 cases of cervical polyp, 2 cases of cervicitis, 8 cases found koilocytes, 3 cases of low level lesions, 4 cases of high level lesions, 1 case of cervical invasive squamous cell carcinomas. With the increase of the classification level of TBS in TCT, the probability of pathological changes above the high grade lesions of cervical biopsy increased（P〈0.05）. The incidence of the high grade lesions of cervical in HPV-positive patients was higher than that of HPV-negative patients, the difference was statistically significant（P〈0.05）. Conclusion Cervical cancer screening is of great value for early detection of cervical cancer and precancerous lesions and identification of high-risk groups.