11995例子宫颈上皮内瘤变患者年龄及活检部位病理情况分析

Pathological changes of cervical intraepithelial neoplasia in 11 995 patients

目的通过回顾分析患者的年龄及其变化,并分析宫颈鳞状上皮内病变的活检部位,寻找宫颈最易发生病变的位置,探讨患者的宫颈随机取材检查活检阳性率情况。方法回顾分析2011—2017年深圳市妇幼保健院病理科宫颈活检诊断宫颈上皮内瘤变患者病变程度、年龄及活检的位点。结果 11 995例患者平均年龄为(36.32±8.63)岁。5 206例LSIL变患者平均年龄(35.17±8.21)岁。6 789例HSIL患者平均年龄为(37.22±9.17)岁。26～<36岁和36～<46岁年龄段占宫颈上皮内瘤变的43.89%、31.28%。宫颈1～12点,CIN病变阳性率分别为51.49%、54.46%、51.54%、55.81%、62.60%、61.62%、66.15%、63.32%、55.74%、57.11%、62.98%及54.60%,整体阳性率差异有统计学意义(χ~2=117,P<0.05)。以阳性率最高的7点为参照,其他各点与其两两比较的χ~2值分别为41.0、22.8、37.2、17.8、2.3、4.8、1.6、19.6、17.3、1.8、31.5,其中1、2、3、4、9、10、12点P均小于0.004 5(Bonferroni法校正),差异有统计学意义。宫颈活检12个位点,病变检出率其中7点最高、其次8点、11点、5点、6点、10点、4点、9点、12点、2点、3点和1点。结论宫颈上皮内瘤变主要集中在26～<46岁年龄段。LSIL患者年龄集中在(35.17±8.21)岁,HSIL患者年龄集中在(37.22±9.17)岁。宫颈病变患者活检部位7点、8点、11点、5点、6点、10点可能是最易首先发生宫颈病,选择这六个点位活检检查可能对提高宫颈病变的阳性检出率。

Objective Through retrospective analysis of the patient＇s age and its changes, and the biopsy site of cervical squamous intraeplthellal lesions, to hnd the most vulnerable cervical lesions location, to explore the positive rate oI cervical biopsy. Methods Retrospective analysis was performed on the pathological extent, age and biopsy site of cervical intraepithelial neoplasia diagnosed by cervical biopsy from Department of Pathology of Shenzhen Maternal and Child Health Hospital from 2011 to 2017. Results The average age of 11 995 patients was （36.32±8.63） years. The average age of 5 206 patients with low-grade squamous intraepithelial lesion （LSIL） was （35.17±8.21） years. The average age of 6 789 patients with high-grade squamous intraepithelial lesion （HSIL） was （37.22±9.17） years. The ages of 26 to 36 and 36 to 46 accounted for 43.89% and 31.28% of cervical intraepithelial neoplasia. From 1 to 12 o＇clock in the cervix, the positive rates of cervical intraepithelial ueoplasia （CIN） lesions were 51.49%, 54.46%, 51.54%, 55.81%, 62.60%, 61.62%, 66.15%, 63.32%, 55.74%, 57.11%, 62.98%, and 54.60%, respectively. There was significant difference in the overall positive rate （χ^2=117, P〈0.03）.Taking the 7 points with the highest positive rate as the reference, the χ^2 test values that the other points compared with it were 41.0, 22.8, 37.2, 17.8, 2.3, 4.8, 1.6, 19.6, 17.3, 1.8, and 31.5, respectively. The P values of 1, 2, 3, 4, 9, 10, and 12 points were all less than 0.004 5 （Bonferroni correction）, and the differences were statistically significant. Among the 12 sites of cervical biopsy, the detection rate of lesions at 7 points was the highest, followed by 8, 11, 5, 6, 10, 4, 9, 12, 2, 3 and 1. Conclusion Cervical intraepithelial neoplasia is mainly concentrated in the 26 to 46 age group. The age of LSIL patients is （36.17±8.21） years old, and the age of HSIL patients is （37.22±9.17） years old. The biopsy site of cervical lesions at 7, 8, 11, 5, 6, 10 may be the most likely first occurrence of cervical disease, the selection of these six biopsies may increase the positive detection rate of cervical lesions.