非洲马里女性宫颈癌前病变联合筛查的调查分析

Investigation and analysis of cervical precancerous lesions combined screening for Malian women in Africa

目的筛查西非马里女性宫颈癌前病变的流行病学特征,为制定相应的干预措施提供依据。方法筛查对象来自西非马里2015年1月-2017年11月年龄为(39. 85±14. 21)岁女性1 830例,进行妇科常规检查、醋酸肉眼观察(VIA)、碘液染色肉眼观察法(VILI)、宫颈细胞学、阴道镜检查及组织病理学筛查。结果 1 830例VIA/VILI检测的敏感度为87. 67%(128/146),特异度为71. 38%(1 202/1 684); 610例细胞学宫颈癌前病变阳性检出率为20. 98%,其中首次性交年龄为15岁～20岁患者的发生癌前病变阳性检出率为10. 49%;年龄为40岁～50岁的癌前病变阳性检出率为6. 39%; 125例女性组织学宫颈癌前病变阳性检出率为76. 19%,CINⅡ及以上级别病变阳性检出率为55. 56%。结论通过本次对子宫颈癌前病变的调查发现导致宫颈病变高发与一夫多妻、首次性交年龄、医疗卫生等因素有关。

Objective To screen out the epidemiological characteristics of cervical precancerous lesions for Malian women in West Africa and provide basis for the prevention measures. Methods A total of 1 830 woman aged 39. 85 ± 14. 21 years from January 2015 to November 2017 from Mali,West Africa,were chosen as screening subjects. Examination methods included routine gynecological examination,visual inspection of acetic acid（ VIA）,visual inspection with Lugol＇s iodine（ VILI）,cervical cytology,colposcopy,and histopathology combined screening. Results The sensitivity of VIA and VILI detection for 1 830 women were 87. 67%（ 128/146）,and the specificity was 71. 38%（ 1 202/1 684）. The positive rate of cervical precancerous lesions for 610 women in cytology was 20. 98%. Among them,for women with first sexual intercourse during 15-20 years old,the rate was 10. 49%. For women during 40-50 years old,the rate was 6. 39%. The positive rate of cervical precancerous lesions for 125 women in female histology was 76. 19%. And the positive detection rate of CIN Ⅱ and above grade was55. 56%. Conclusion According to the cervical precancerous lesion research results,we found that high incidence of cervical disease in west Africa was due to polygamy,early first sexual intercourse,lack of medical conditions and other factors.