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目的对泰安市宫颈癌筛查情况进行分析,为探讨适宜宫颈癌的筛查模式提供参考。方法 2010年10月对泰安市岱岳区所辖乡镇6 830名已婚妇女开展宫颈癌筛查。采用专用宫颈刷收集宫颈及颈管脱落细胞,放入盛有专用保存液的标本瓶中,制成薄层细胞涂片,进行Feulgen DNA染色做DNA定量测定,由全自动DNA倍体定量分析系统进行扫描。用DNA指数(DNA index,DI)代表细胞核的DNA含量,DI>2.5为异常细胞,异常细胞称为异倍体细胞。如检查未见异倍体细胞,建议按常规定期筛查;见1~2个异倍体细胞或细胞增殖比例5%~10%,建议4~6个月复查;≥3个异倍体细胞或者细胞增殖比例>10%,均建议行阴道镜检查、宫颈组织活检。组织学病理诊断包括:(1)正常或炎症;(2)宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN):分为CINⅠ、CINⅡ、CINⅢ及原位癌;(3)浸润癌。数据输入Excel2003,进行描述性分析。结果 6 830名已婚妇女中异倍体细胞检出率8.39%,1~2个检出率5.81%,≥3个检出率2.58%。阴道镜下活检,CINⅡ及以上病变51例,患病率为0.75%。原位癌患病率为0.04%,浸润癌患病率为0.03%。30~45岁CIN和宫颈癌高发,其中30~35岁、35~40岁、40~45岁CINⅠ、CINⅡ、CINⅢ、原位癌、浸润癌患病率分别为1.84%、0.70%、0.61%、0.09%、0.09%,1.23%、0.65%、0.39%、0.06%、0,0.82%、0.16%、0.25%、0.08%、0。结论全自动DNA倍体定量分析系统可以作为宫颈癌可靠方法,同时加强宣传、提高筛查覆盖率、规范宫颈病变的早诊早治技术,可降低宫颈癌的患病率和病死率。
Objective To analyze the screening status of cervical cancer in Tai’an City and provide reference for screening screening mode suitable for cervical cancer. Methods In October 2010, cervical cancer screening was carried out in 6 830 married women in villages and towns under the jurisdiction of Daiyue District, Tai’an City. A special cervical brush was used to collect exfoliated cervical and cervical canal cells and placed in a sample bottle containing a special preservation solution to make a thin layer smear. The DNA was quantified by Feulgen DNA staining and quantified by an automated DNA ploidy quantitative analysis system Scan. DNA index (DNA index, DI) represents the DNA content of the nucleus, DI> 2.5 for abnormal cells, abnormal cells called aneuploid cells. If the examination did not see aneuploid cells, it is recommended routine screening routine; see 1 to 2 aneuploid cells or cell proliferation ratio of 5% to 10%, recommended 4 to 6 months review; ≥ 3 aneuploid cells Or cell proliferation rate> 10%, are recommended colposcopy, cervical biopsy. Histological pathological diagnosis include: (1) normal or inflammatory; (2) cervical intraepithelial neoplasia (CIN): divided into CIN Ⅰ, CIN Ⅱ, CIN Ⅲ and carcinoma in situ; Data input Excel2003, for descriptive analysis. Results Among 6 830 married women, the detection rate of aneuploid cells was 8.39%, the detection rates of 1 ~ 2 were 5.81%, and the detection rates of ≥ 3 were 2.58%. Colposcopy biopsy, CIN Ⅱ and above lesions in 51 cases, the prevalence was 0.75%. The prevalence of carcinoma in situ was 0.04% and the prevalence of invasive carcinoma was 0.03%. The prevalence of CIN and cervical cancer was 30-45 years old, among which the prevalence of CINⅠ, CINⅡ, CINⅢ, CAG, invasive carcinoma were 30-35, 35-40, 40-45 years old were 1.84%, 0.70%, 0.61% , 0.09%, 0.09%, 1.23%, 0.65%, 0.39%, 0.06%, 0,0.82%, 0.16%, 0.25%, 0.08% Conclusion The automatic DNA ploidy quantitative analysis system can be used as a reliable method for cervical cancer. At the same time, it can enhance publicity, improve screening coverage and standardize the early diagnosis and treatment of cervical lesions, which can reduce the prevalence and mortality of cervical cancer.