2014年-2018年宁波地区宫颈癌筛查情况分析

Analysis of cervical cancer screening in Ningbo from 2014 to 2018

目的通过对宁波地区女性宫颈癌筛查结果及变化趋势,分析当地女性宫颈健康状况,为制定防治措施提供依据。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等。统计人乳头状瘤病毒(HPV-DNA)、液基薄层细胞学(TCT)单一检测及联合检测结果,比较阳性检测率。并对该地区2014年1月-2018年12月宫颈癌筛查中发现的问题进行回顾性统计分析。结果宫颈癌筛查331 548例,组织病理学检查人次数44 328例(13.37%)。低度病变(原CINⅠ)检出11 780例,检出率为26.57%;高度病变(原CINⅡ和CINⅢ)检出4 791例,检出率为10.81%;宫颈癌检出1 291例,检出率为2.91%。CINⅢ及宫颈癌患者呈逐年下降趋势。TCT和HPV联合检测阳性率高于单一TCT或HPV检测(P <0.05)。结论及时发现宫颈疾病,降低宫颈癌的发生率,应尽早在全市重点人群开展宫颈癌普查工作。联合HPV-DNA和TCT检测对宫颈病变有较高的诊断价值,值得推广应用。

Objective To analyze the cervical health of local women through screening results and trends of cervical cancer in Ningbo,so as to provide basis for prevention and control measures. Methods Gynecological examination,vaginal wet microscopy and cervical cytology were used. Abnormal or suspicious smears were examined with colposcopy and biopsy. The results of single and combined detection of human papillomavirus( HPV-DNA) and liquid-based thin-layer cytology( TCT) were counted and the positive detection rates were compared. A retrospective statistical analysis was conducted on problems identified during cervical cancer screening in the region between January 2014 and December 2018. Results Cervical cancer were screened in 331 548,of which 44 328 cases were with histopathological examination( 13. 37%) Low-grade lesions( original CIN Ⅰ) were detected in 11 780 cases( 26. 57%);highly lesion( CIN Ⅱ and CIN Ⅲ) was detected in 4791 cases( 10. 81%);1 291 cases of cervical cancer were detected,and the detection rate was 2. 91%. CIN Ⅲ and cervical cancer patients decline year by year. CIN Ⅲ and cervical cancer patients were with a declining trend year by year. The positive rate of TCT combined with HPV was higher than that of TCT alone or HPV alone( P < 0. 05). Conclusion To detect cervical diseases in time and reduce the incidence of cervical cancer,cervical cancer screening should be carried out in the key population of the city as soon as possible. The combination of HPV-DNA and TCT detection has a high diagnostic value for cervical lesions,which is worthy of popularization and application.