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[目的]通过分析襄垣县2009~2015年农村妇女宫颈癌筛查结果,为国家宫颈癌筛查项目的评价和优化提供理论依据。[方法]对襄垣县35~64岁妇女开展宫颈癌筛查。2009~2013年采用醋酸/碘染色后肉眼观察(VIA/VILI),2014年开始部分引入人乳头状瘤病毒(HPV)检测,2015年又引入新柏氏液基细胞学(TCT)检测,根据卫生资源情况在不同人群中分别使用三种方法。任意筛查结果阳性者转诊阴道镜,镜下有病变时取活检,以病理诊断为金标准。通过评价不同方法对宫颈上皮内瘤变(CIN)2级及以上病变的检出率评价不同方法对宫颈癌的筛查效果。[结果]2009~2015年共筛查62 618名女性,其中CIN2级及以上(CIN2+)病变的患病率为0.76%,早诊率为90.53%,下生殖道感染率为25.68%,其中滴虫性阴道炎、细菌性阴道炎和宫颈炎与HPV感染相关。根据2014及2015年数据,VIA/VILI的CIN2+病变检出率为0.74%,TCT的病变检出率为0.70%,两者相似,但均低于HPV检测,其病变检出率为1.37%。[结论 ]HPV检测是首选的宫颈癌初筛方法 ,在资源匮乏地区,培训合格的基层医生使用VIA/VILI或TCT方法对适龄妇女开展宫颈癌筛查是有效的备选方案。
[Objective] By analyzing the results of cervical cancer screening among rural women from 2009 to 2015 in Xiangyuan County, the theoretical basis for the evaluation and optimization of the national cervical cancer screening program was provided. [Methods] To carry out cervical cancer screening in women aged 35 ~ 64 in Xiangyuan County. Visual inspection (VIA / VILI) was performed after acetic acid / iodine staining from 2009 to 2013, and part of human papillomavirus (HPV) detection was introduced at the beginning of 2014. In addition, Neobromide-based cytology (TCT) Resources in different groups were used in three ways. Positive results of any screening referral colposcopy, microscopic examination of lesions taken to pathological diagnosis as the gold standard. To evaluate the different screening methods for cervical cancer by evaluating the detection rate of cervical intraepithelial neoplasia (CIN) grade 2 and above by different methods. [Results] A total of 62 618 women were screened from 2009 to 2015, of which the prevalence rate of CIN2 + grade CIN2 + was 0.76%, the rate of early diagnosis was 90.53% and the rate of lower genital tract infection was 25.68% Insect vaginitis, bacterial vaginosis and cervicitis associated with HPV infection. According to the data of 2014 and 2015, the detection rate of CIN2 + lesions in VIA / VILI was 0.74% and the detection rate of TCT in lesions was 0.70%, both of which were lower than that of HPV, and the detection rate of lesions was 1.37%. [Conclusion] HPV test is the first screening method for cervical cancer. In resource-scarce areas, trained primary doctors use VIA / VILI or TCT as an effective alternative to cervical cancer screening in women of the same age.