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目的探讨宫颈癌机会性筛查的临床意义。方法采用高危患者认知干预、液基薄层宫颈/阴道脱落细胞(TCT)、人乳头瘤病毒(HPV)、阴道镜检查及活组织检查“三阶梯”诊断原则进行筛查诊断,对2010年9月至2011年9月2 411例普通妇科门诊患者进行宫颈癌筛查。结果 2 411例检测病例中,HPV感染阳性病例共403例,阳性感染率16.72%。其中高危单重阳性占70.47%,低危单重阳性占9.68%,高危混合阳性感染占13.65%,高低危混合阳性感染占6.20%。20岁及以下年龄段的病例HPV感染阳性率最高,占32.14%;其次为~25岁年龄组,占28.89%;~55岁年龄组及56岁以上两个年龄组,又出现HPV感染增加现象,分别占22.22%及20.17%。宫颈上皮内瘤变(CIN)I检出14例,CINⅡ检出27例,CINⅢ检出16例,宫颈癌检出22例。HPV高危组与低危组宫颈病变类型差异有统计学意义(P<0.01)。结论通过宣教和认知干预,可提高患者对宫颈癌的认知度,对临床开展宫颈癌的早诊早治有重要意义。
Objective To investigate the clinical significance of opportunistic screening of cervical cancer. Methods High-risk patients with cognitive intervention, liquid-based thin cervical / vaginal exfoliated cells (TCT), human papillomavirus (HPV), colposcopy and biopsy "three ladder September 2011 to September 2011 2 411 cases of general gynecological clinic patients with cervical cancer screening. Results Among the 411 cases detected, 403 cases were positive for HPV infection, the positive rate was 16.72%. High-risk single positive accounted for 70.47%, low-risk single positive accounted for 9.68%, high-risk mixed positive infection accounted for 13.65%, high and low risk mixed positive infection accounted for 6.20%. The highest positive rate was HPV infection in the age group of 20 years old and below, accounting for 32.14%; followed by the 25-year-old age group, accounting for 28.89%; the HPV infection increased again in the 55-year-old group and the 56-year-old group , Accounting for 22.22% and 20.17% respectively. In 14 cases of cervical intraepithelial neoplasia (CIN) I, 27 cases were detected by CINⅡ, 16 cases were detected by CINⅢ and 22 cases were detected by cervical cancer. There were significant differences in the types of cervical lesions between high risk HPV and low risk group (P <0.01). Conclusion Through the missionary and cognitive intervention, the awareness of cervical cancer in patients can be improved, which is of great significance for the early diagnosis and treatment of cervical cancer in clinical practice.