發(fā)布時(shí)間：2018-03-30 18:00

  本文選題：宮頸腫瘤　切入點(diǎn)：多相篩查　出處：《中華疾病控制雜志》2017年05期

【摘要】：目的分析人乳頭瘤病毒(human papillomavirus,HPV)檢測(cè)技術(shù)初篩巴氏涂片分流應(yīng)用于農(nóng)村女性宮頸癌篩查中的效果。方法 2015年對(duì)35~64歲農(nóng)村女性使用HPV檢測(cè)進(jìn)行宮頸癌初篩,陽性者采用巴氏涂片法分流,巴氏涂片結(jié)果為不明確意義的非典型鱗狀細(xì)胞(atypical squamous cells of undetermined signification,ASCUS)及以上病變的女性轉(zhuǎn)用陰道鏡檢查。所有陰道鏡下檢查異�；虿粷M意處均取活檢或?qū)m頸管搔刮術(shù)(endocervical canal curettage,ECC),病理結(jié)果為中度子宮頸上皮內(nèi)瘤變(cervical intraepithelial neoplasia grade 2,CIN2)及以上者轉(zhuǎn)診進(jìn)行手術(shù)治療。結(jié)果 HPV初篩、巴氏涂片分流策略HPV篩查陽性率為10.65%。CIN2及以上者共150人,全部進(jìn)行陰道鏡檢查,實(shí)際陰道鏡轉(zhuǎn)診率為3.55%,陰道鏡順應(yīng)性為100%。經(jīng)病理診斷,本次篩查分別發(fā)現(xiàn)輕度子宮頸上皮內(nèi)瘤變(cervical intraepithelial neoplasia grade 1,CIN1)、CIN2及以上、重度子宮頸上皮內(nèi)瘤變(cervical intraepithelial neoplasia grade 3,CIN3)及以上分別為16例(0.38%)、29例(0.69%)、15例(0.36%),未發(fā)現(xiàn)宮頸癌病例。結(jié)論 HPV初篩、巴氏涂片分流策略能夠降低陰道鏡轉(zhuǎn)診率,宮頸疾病檢出率較高,可以在有條件的農(nóng)村地區(qū)使用。但宮頸癌前病變及宮頸癌的檢出率較HPV初篩不分流低,需要進(jìn)一步加強(qiáng)對(duì)基層細(xì)胞學(xué)醫(yī)生技術(shù)水平的規(guī)范化培訓(xùn)。
[Abstract]:Objective to analyze the effect of screening pasteurized smear shunt with human papillomavirus (HPV) technique in screening cervical cancer in rural women. Methods in 2015, 35 ~ 64 years old rural women were screened by HPV. The positive patients were shunt by pasteurized smear. Atypical squamous cells of undetermined significance of atypical squamous cells of undetermined verification ASCUSS) and above were switched to colposcopy. Biopsy or cervical canal scratching of endocervical canal were performed in all cases of abnormal or unsatisfactory findings under colposcopy. The pathological results were moderate cervical intraepithelial neoplasia (intraepithelial neoplasia grade 2CIN2) and above. Results HPV was first screened. The positive rate of HPV screening for pasteurized smear shunt strategy was 150 people with 10.65%.CIN2 and above. All of them underwent colposcopy examination. The actual colposcopy referral rate was 3.55 and the colposcopy compliance was 100. In this screening, cervical intraepithelial neoplasia grade 1 was found to be cervical intraepithelial neoplasia and CIN2 +, and severe cervical intraepithelial neoplasia grade 3CIN3 was found in 16 patients with cervical intraepithelial neoplasia and above, respectively. 29 cases of cervical intraepithelial neoplasia and above were 0.38 and 0.69%, 15 cases were 0.366.Conclusion No cases of cervical cancer were found. The pasteurized smear shunt strategy can reduce the rate of colposcopy referral, the detection rate of cervical diseases is higher and can be used in conditional rural areas, but the detection rate of precancerous lesions and cervical cancer is lower than that of HPV screening. Need to further strengthen the basic level of cytology doctors technical level standardized training.
【作者單位】： 河南省新密市婦幼保健院保健科;上海市計(jì)劃生育科學(xué)研究所生殖流行病與社會(huì)醫(yī)學(xué)研究室;四川省腫瘤醫(yī)院·研究所癌癥防治中心辦公室;北京協(xié)和醫(yī)學(xué)院/中國(guó)醫(yī)學(xué)科學(xué)院腫瘤醫(yī)院流行病學(xué)研究室;
【基金】：重大公共衛(wèi)生專項(xiàng)(2100409)
【分類號(hào)】：R737.33

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