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目的 探讨绝经后妇女宫颈病变的特点、筛查的必要性及早期诊断。方法 对北京大学第三医院自2 0 0 1年 1月至 2 0 0 4年 1月因宫颈涂片异常或临床检查可疑宫颈病变者 934例进行总结分析。根据绝经与否分为未绝经组和绝经组 ,对患者行宫颈涂片、阴道镜下宫颈多点活检。结果 未绝经组及绝经组宫颈异常涂片的检出率分别为 6 8 2 6 % (40 0 / 5 86 )及 85 31% (2 73/ 32 0 ) ,二组比较差异有显著性意义 (P <0 0 5 )。阴道镜下宫颈活检组织病理学诊断宫颈上皮内瘤变 (cervicalintraepithelialneoplasia ,CIN)分别为 2 4 34% (138/ 5 6 7)及 15 0 6 %(5 0 / 332 ) ,二组比较差异有显著性意义 (P <0 0 5 ) ;其中CINⅢ的检出率分别为 8 99% (5 1/ 5 6 7)及 8 73%(2 9/ 332 )。未绝经组与绝经组涂片及组织病理学提示人乳头瘤病毒 (humanpapillomavirus ,HPV)感染共 138例 ,其中高危型HPV阳性率分别为 6 2 2 2 % (5 6 / 90 )和 4 3 75 % (2 1/ 4 8) ,二组比较差异有显著性意义 (P <0 0 5 )。结论 为早期发现宫颈病变 ,阻遏疾病进展为宫颈癌 ,在绝经后妇女进行宫颈细胞学筛查是必要的。
Objective To investigate the characteristics of cervical lesions in postmenopausal women, the necessity of screening and early diagnosis. Methods From January 2001 to January 2004, 934 cases of suspected cervical lesions due to abnormal cervical smears or clinical examination of Peking University Third Hospital from January 2001 to January 2004 were analyzed. According to menopause or not into the menopause group and the menopause group, the patient underwent cervical smears, colposcopy under the biopsy of the cervix. Results The detection rates of cervical abnormal smear in non-menopausal group and menopause group were 6826% (40 0/586) and 8531% (2 73/32 0), respectively, with significant difference between the two groups ( P <0 0 5). The colposcopic biopsy histological diagnosis of cervical intraepithelial neoplasia (CIN) was 24.44% (138/567) and 150.6% (50/323) respectively, with significant difference between the two groups (P <0.05). The detection rates of CINⅢ were 899% (51/56) and 873% (29/322), respectively. In non-menopausal and postmenopausal women, smear and histopathology suggested a total of 138 cases of human papillomavirus (HPV) infection, of which the high-risk HPV positive rates were 6222% (56/90) and 4375 % (2 1/48), there was significant difference between the two groups (P <0 05). CONCLUSIONS: Early detection of cervical lesions and suppression of disease progression to cervical cancer are necessary for cervical cytology screening in postmenopausal women.