2015—2016年东营市南部地区农村中老年妇女宫颈癌筛查结果分析

Analysis of screening results of cervical cancer in rural middle-aged and elderly women in the southern part of Dongying City from 2015 to 2016

目的探讨液基薄层细胞学(TCT)检查、高危型人乳头瘤病毒(HPV)检测及两者联合检测在宫颈癌筛查中的应用价值。方法 2015年5月至2016年10月,经宣传后对东营南部地区已婚或有性生活史的9 982例中老年农村妇女进行宫颈癌免费筛查。先行妇科检查、宫颈液基薄层细胞学检测、高危型人乳头瘤病毒12+2分型检测;对检查结果TCT阳性、HPV阳性及2项同时为阳性的病例,进一步进行阴道镜检查和宫颈多点活检及宫颈管搔刮病理学检查;并建立电子个人档案,与乡镇卫生院建立双向反馈机制,定期随访。结果 TCT+HPV联合检测在CIN的阳性表达率随病变程度加重而上升,其中CINⅢ的阳性表达率为70.81%、SCC的阳性表达率为100%;作为宫颈癌的初筛手段,HPV和TCT联合检测在CIN的检出率高于单纯TCT检查或单纯HPV检测,HPV联合TCT检测能提高宫颈癌前病变的检出率。结论在对宫颈病变的筛查中,TCT联合HPV检测可提高宫颈病变的检出率,可在临床广泛开展应用。

Objective To evaluate the value of liquid-based cytology, high-risk human papilloma virus detection and combined detection in cervical cancer screening.Methods From May 2015 to October 2016, 9 982 middle-aged and elderly rural women who were married or had sexual life history in the southern region of dongying were screened for cervical cancer free of charge after publicity. Gynecological examination, cervical liquid-based thin layer cytology test and high-risk HPV 12+2 typing test were performed first. For TCT positive, HPV positive and both positive cases, further colposcopy and cervical multi-point biopsy and cervical tube scratch pathology examination、 And the establishment of electronic personal files, and township hospitals to establish a two-way feedback mechanism, regular follow-up.Results TCT+HPV combined detection in CIN the positive expression rate of rise, according to the pathological changes degree aggravating in CIN Ⅲ reached 70.81%, reached 100% in SCC. As a screening method for cervical cancer, the detection rate of HPV combined with TCT in CIN is significantly higher than that of TCT alone or HPV alone. HPV combined with TCT can significantly improve the detection rate of cervical cancer prelesions.Conclusion In the screening of cervical lesions, TCT combined with HPV detection can significantly improve the positive rate of cervical lesions, effectively reduce the incidence of cervical cancer in middle-aged and elderly women in the south of Dongying, and can be widely used in clinical practice.