陕西省安康市农村妇女宫颈癌筛查结果分析

Cervical cancer screening among rural women in Ankang City of Shaanxi

目的通过对陕西省安康汉滨区10个镇农村妇女的宫颈癌筛查,了解当地农村宫颈癌前病变、宫颈癌的患病情况。方法采用妇科常规检查、阴道分泌物湿片显微镜检查、宫颈脱落细胞学检查,对出现异常或可疑细胞涂片时做阴道镜检查并取活组织检查。结果宫颈癌筛查10 149例,宫颈脱落细胞学检查中,正常9 875例,发现异常细胞274例(2.70%),其中不能明确诊断意义的不典型鳞状细胞167例(1.64%),低度鳞状上皮内病变87例(0.86%),不能排除高级别鳞状上皮内病变的不典型鳞状细胞14例(0.14%),高度鳞状上皮内病变6例(0.05%)。所有细胞学异常者均进行阴道镜及活组织病理检查,共检出宫颈上皮内瘤变16例,其中宫颈上皮内瘤变Ⅰ级3例,宫颈上皮内瘤变Ⅱ级7例,宫颈上皮内瘤变Ⅲ级6例,包括宫颈浸润癌4例。采用多样本比较的秩和检验,在不同年龄段宫颈脱落细胞异常率比较差异有统计学意义(χ~2=33.657,P=0.000);不同年龄段宫颈癌前病变患病率比较差异有统计学意义(χ~2=16.941,P=0.002)。结论安康汉滨区10个镇农村妇女宫颈上皮内瘤变、宫颈癌发病率较高,需加强宫颈癌知识的宣教。

Objective To understand the prevalence of cervical precancerous lesions and cervical cancer in rural areas by screening of ten towns of the Hanbin district Ankang city,Shaanxi province.Methods Gynecological examination,vaginal wet microscopy and cervical cytology were used.Abnormal or suspicious smears were examined with the colposcopy and biopsy.Results Cervical cancer were screened in 10 149 cases with cervical cytology examination,of which 9 875 cases were normal and 274(2.70%)were abnormal.Among 274 cases of abnormal cells,there were 167 cases(1.64%)of atypical squamous cells,87 cases(0.86%)of low squamous intraepithelial lesion,14 cases(0.14%)of atypical squamous cells and 6 cases(0.05%)of high squamous intraepithelial lesion.All patients with abnormal cytology underwent colposcopy and biopsy,and cervical intraepithelial neoplasia was found in 16 cases,including 3 cases of cervical intraepithelial neoplasias(CIN)Ⅰ,7 cases of CINⅡand 6 cases of CINⅢ,and there were 4 cases of invasive cervial cancer.Rank Sum test result showed that the abnormal rates of cervical exfoliated cells in different age groups were significantly different(χ^2=33.657,P=0.000);the prevalence rates of cervical precancerous lesions in different age groups were significantly different(χ^2=16.941,P=0.002).Conclusions The rural women in 10 towns of Hanbin District have high incidence of cervical intraepithelial neoplasia and cervical cancer.The knowledge of cervical cancer should be publicized.