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目的建立一个实用，有效的宫颈原位癌的筛选诊断方法。方法对２５岁以上已婚妇女采用“四步”检查法。结果发现１３６例宫颈原位癌。患者平均年龄为４４．１０岁，无临床症状者占５０．７５％，宫颈光滑者为４４．７８％，宫颈糜烂者占５５．２２％。“四步”检查中，阳性率依次为８．９６％，８３．５８％、３．７３％及３．７３％。宫颈和颈管同时检查时阳性率（１００％）比单项宫颈（９０．９８％）或颈管（８４．４２％）检查的阳性率高。３５例作亚连续切片，发现宫颈１～１２点均可发生癌，以１０点处检出率最高（４８．５７％），６点处次之（４２．８６％）。结论在农村普查中采用“四步”检查法是很有实用价值的，一次涂片阴性不能完全排除癌的存在，要结合临床综合判断，同时取宫颈及颈管两个涂片。
Objective To establish a practical and effective screening method for cervical carcinoma in situ. Methods For married women over 25 years of age using the “four-step” test. 136 cases of cervical carcinoma in situ were found. The average age of patients was 44.10 years old, without clinical symptoms accounted for 50.75%, smooth cervical 44.78%, cervical erosion accounted for 55.22%. In the “four steps” examination, the positive rates were 8.96%, 83.58%, 3.73% and 3.73%, respectively. The positive rate of both cervical and cervical canal examination (100%) was higher than that of single cervical canal (90.98%) or cervical canal (84.42%). 35 cases were subcutaneously subcutaneously. It was found that carcinoma occurred at 1 ~ 12 points in cervix. The highest detection rate was found at 10 o’clock (48.57%), followed by 6 points (42.86%). Conclusions The “four-step” test in rural census is of great practical value. A negative smear can not completely exclude the presence of cancer. Combined with clinical judgment, cervical smear and cervical canal smear should be taken simultaneously.