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目的了解不同的筛查方法对宫颈癌和癌前病变检出率的影响,以及在不同民族、年龄和文化程度等方面的分布特点。方法采用χ~2检验和Fisher确切概率法,对用不同筛查方法筛出的宫颈癌和癌前病变患者的发病情况进行比较分析,并对其初筛结果、民族、年龄和文化程度的分布进行统计分析。结果采用人乳头状瘤病毒(humanpapillomavirus,HPV)联合液基薄层细胞学技术(thinprep cytologic test,TCT)所筛出的宫颈癌和癌前病变检出率高于仅用TCT进行筛查的检出率,差异具有统计学意义(P<0.05);低级别宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN1)患者初筛结果中不典型鳞状上皮细胞(atypical squamous cells of undetermined signification,ASC-US)比例最高,高级别宫颈上皮内瘤样病变(CIN2、CIN3)、原位腺癌(adenocarcinoma in situ,AIS)、微小浸润癌和浸润癌患者初筛结果均为高度鳞状上皮内病变(high grade squamous intraepithelial lesion,HSIL)的比例最高;宫颈癌前病变患者在35~44岁、汉族、初中文化程度的妇女中比例最高,宫颈癌患者在45~54岁、汉族、初中文化程度的妇女中比例最高。结论 HPV联合TCT筛查的方法能有效提高宫颈癌和癌前病变的检出率;在不断探索和总结更为经济有效的筛查方案的同时,各地应因地制宜,加强对高危人群的宣教和跟踪随访,切实提高宫颈癌的早诊早治率。
Objective To understand the influence of different screening methods on the detection rate of cervical cancer and precancerous lesions and their distribution characteristics in different ethnic groups, ages and educational levels. Methods The Chi-square test and Fisher’s exact test were used to analyze the incidence of cervical cancer and precancerous lesions screened by different screening methods. The results of screening, ethnicity, age and educational level conduct statistical analysis. Results The detection rate of cervical cancer and precancerous lesions screened by human papillomavirus (HPV) combined with thinprep cytologic test (TCT) was higher than that of screening by TCT alone (P <0.05). Atypical squamous cells of undetermined lesion (ASC-1) were detected in low-grade cervical intraepithelial neoplasia (CIN1) US). The primary screening results of high grade cervical intraepithelial neoplasia (CIN2, CIN3), adenocarcinoma in situ (AIS), minimally invasive carcinoma and invasive carcinoma were all highly squamous intraepithelial lesions high grade squamous intraepithelial lesion (HSIL)). The proportion of women with cervical precancerous lesions was 35-44 years old, the highest proportion was Han and junior high school education, while the incidence of cervical cancer was 45-54 years. Han women and women with junior high school education The highest proportion. Conclusion HPV combined with TCT screening method can effectively improve the detection rate of cervical cancer and precancerous lesions; continue to explore and summarize the more cost-effective screening programs at the same time, various localities should be tailored to local conditions, to strengthen the mission of high-risk groups and tracking Follow-up, and earnestly improve early diagnosis and treatment of cervical cancer rate.