一种新型宫颈刷的设计及其在宫颈癌筛查中的应用

A new cervical cytology brush and its clinical application in cervical cancer screening

目的:介绍一种新型宫颈刷,探讨其在宫颈癌筛查中的实用性。方法:详述本新型宫颈刷的结构及工作原理。选取2017年3月至2018年1月于温州医科大学附属第二医院就诊,以传统宫颈刷法进行宫颈癌筛查时"宫颈细胞学异常或高危型人乳头瘤病毒(HPV)阳性"的30例患者为研究对象,采用新型宫颈刷刷取患者宫颈鳞柱交界区上皮脱落细胞,分析比较两种宫颈刷法刷取标本的满意率、异常细胞检出率及HPV阳性检出率。结果:传统宫颈刷法与新型宫颈刷法标本满意率均为100%;传统宫颈刷法异常细胞检出率为76.7%,HPV阳性检出率为83.3%,新型宫颈刷法异常细胞检出率为63.3%,HPV阳性检出率为76.7%,两种方法一致性较好(Kappa>0.75)。结论:本新型宫颈刷可以有效地刷取宫颈脱落细胞,异常细胞检出率和HPV阳性检出率与传统宫颈刷相似,同时该新型宫颈刷能有效地简化宫颈癌筛查的流程,为宫颈癌筛查提供便利。

Objective： To introduce a new type of cervical cytology brush and to investigate its clinical ap-plication in the cervical cancer screening. Methods： The structure and operating principles of this new cervical cytology brush were described in detail. Thirty women with abnormal cytology or high-risk human papillomavi-rus （HPV） positive via the traditional cytology brush in the Second Affliated Hospital of Wenzhou Medical Uni-versity from March 2017 to January 2018 were selected. According to instructions, samples of cervical exfoliate cells were collected using a new cytology brush later. The rates of satisfactory cytology specimen, abnormal cy-tology and HPV positive in two groups were evaluated. Results： The satisfaction rates of cervical cytology speci-men using the new and traditional cytology brush was both 100%. Twenty-three women （76.7%） had abnormal cytology and twenty-fve women （83.3%） tested high-risk HPV positive in the traditional cytology brush group. The rates of abnormal cytology and high-risk HPV positive were 63.3% and 76.7%, respectively, in the new cy-tology brush group. The consistency analysis showed good agreement （kappa〉0.75）. Conclusion： The new type of cervical cytology brush could effectively collect samples of cervical exfoliate cells. It performed similarly to the traditional cervical cytology brush in identifying abnormal cytology and high-risk HPV in cervical cancer screening. Our data suggested that the new cervical cytology brush could be an alternative, more convenient and effcient strategy for cervical cancer screening as compared to traditional cytology brush.