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目的了解九江地区妇女宫颈癌及癌前病变的状况,探讨液基薄层细胞涂片(liquid-based cytology test,LBC)检查及阴道分泌物人乳头瘤病毒(human papilloma virus,HPV)16,18的感染状态检查对早期宫颈癌及癌前病变诊断的临床意义。方法对九江学院附属医院妇科门诊就诊者9 328例进行LBC检查,对其中1 211例患者进行阴道分泌物HPV16,18 DNA检查并对阴道镜宫颈活检病理结果进行研究。结果 LBC阳性病例1 008例中有890例进行了活检,另有接触性阴道出血或不规则阴道流血而LBC阴性病例70例进行了阴道镜下活检,共计960例病理检查结果:正常或慢性炎症807例(84.06%),宫颈上皮内瘤变(cervical intra-epithelial neoplasia,CIN)I级61例(6.35%),CINⅡ级22例(2.29%),CINⅢ级25例(2.60%),宫颈癌45例(4.69%)。9 328例患者中,宫颈癌、CINⅢ、CINⅡ、CIN I检出率分别为0.48%、0.27%、0.24%、0.65%。1 211例患者行阴道分泌物HPV16,18 DNA检查,HPV16,18阳性214例(17.67%)。结论 LBC检查是一种相对准确、可靠的宫颈病变筛查方法,但是仍然有一定的漏检率。如果能结合HPV16,18的检查,可以减少假阴性率,减少漏诊。
Objective To investigate the status of cervical cancer and precancerous lesions in women in Jiujiang region and to investigate the effects of liquid-based cytology test (LBC) and vaginal secretions on human papilloma virus (HPV) Of infection status examination of early cervical cancer and precancerous lesions of clinical significance. Methods A total of 9 328 outpatients with gynecology clinic in Jiujiang University Affiliated Hospital were enrolled in this study. Totally 1121 cases of vaginal secretions were tested for HPV16 and 18 DNA, and colposcopic biopsy results were analyzed. RESULTS: Of the 1 008 cases with LBC positive, 890 were biopsied, and 70 were undergone colposcopic biopsy with contact vaginal bleeding or irregular vaginal bleeding and LBC negative cases. A total of 960 pathological findings were obtained: normal or chronic inflammation 80 cases (84.06%), 61 cases (6.35%) of cervical intra-epithelial neoplasia (CIN), 22 cases (2.29%) of CINⅡ, 25 cases 45 cases (4.69%). Among 9 328 patients, the detection rates of cervical cancer, CINⅢ, CINⅡ and CIN I were 0.48%, 0.27%, 0.24% and 0.65% respectively. 1 211 cases of vaginal discharge HPV16,18 DNA test, HPV16,18 positive 214 cases (17.67%). Conclusion LBC examination is a relatively accurate and reliable screening method for cervical lesions, but there is still a certain missed rate. If combined with HPV16,18 examination, you can reduce the false-negative rate and reduce missed diagnosis.