新疆莎车县妇女宫颈癌筛查结果分析

Analysis of Cervical Cancer Screening Result for Women in Yarkant County of Xinjiang

目的:基于2021年莎车县妇女宫颈癌筛查结果评估本地区人乳头瘤病毒(HPV)感染率及宫颈癌和癌前病变检出率。方法:选取2021年6—10月在莎车县进行宫颈癌筛查的女性5000例为研究对象,均接受HPV初筛,对于初筛HPV阳性者进行细胞学分流。结果:筛查妇女平均年龄为(45.8±6.9)岁。高危型HPV感染率为10.7%(n=537),不同年龄组HPV感染率比较,差异无统计学意义(P=0.366)。HPV阳性者细胞学异常率为24.0%,35~44岁、45~54岁、55~64岁年龄段分别为14.2%、29.3%、44.1%,各组比较,差异有统计学意义(P<0.001)。经过阴道镜检查及病理诊断,共发现12例低级别宫颈上皮内瘤变(CIN 1)、5例高级别宫颈上皮内瘤变(CIN 2~3)、1例宫颈癌患者,对应的检出率分别为0.24%、0.10%、0.02%。文化水平低、既往无宫颈癌筛查史、患有滴虫性阴道炎的女性HPV感染率高,差异有统计学意义(P<0.05)。结论:细胞学分流可能导致一定比例漏诊,应加强当地细胞学医生的规范化培训,真正发挥“HPV初筛+细胞学分流”为主的宫颈癌筛查方案在宫颈癌早诊早治中的作用。

Objective:Based on the results of cervical cancer screening for women in Yarkant County in 2021,the infection rate of human papillomavirus(HPV)and the detection rate of cervical cancer and precancerous lesions in Yarkant County were evaluated.Methods:A total of 5000 women who underwent cervical cancer screening in Yarkant County from June 2021 to October 2021 were selected as the study subjects.They all underwent HPV initial screening,and cytology triage were performed for HPV-positive subjects by initial screening.Results:The mean age of the women screened was(45.8±6.9)years.The high-risk HPV infection rate was 10.7%(n=537),and there was no significant difference in HPV infection rate among different age groups(P=0.366).The cytological abnormality rates of HPV-positive patients were 24.0%,and the rates in age groups of 35-44 years,45-54 years and 55-64 years were 14.2%,29.3%and 44.1%,respectively,and the differences were statistically significant among groups(P<0.001).After colposcopy and pathological diagnosis,a total of 12 patients with low-grade cervical intraepithelial neoplasia(CIN 1),5 high-grade cervical intraepithelial neoplasia(CIN 2-3)and 1 patient with cervical cancer were found,and the corresponding detection rates were 0.24%,0.10%and 0.02%,respectively.The HPV infection rate was high among women with low education level,receiving no previous history of cervical cancer screening,and having trichomonas vaginitis,and the difference was statistically significant(P<0.05).Conclusion:Cytology triage may lead to a certain proportion of missed diagnosis,and the standardized training of local cytology doctors should be strengthened to truly play the role of cervical cancer screening program based on"HPV initial screening+cytology triage"in the early diagnosis and treatment of cervical cancer.