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目的通过分析浦口区江浦街道、泰山街道、石桥三个街道7 185例妇女宫颈癌筛查资料,掌握和了解浦口区宫颈上皮内瘤样病变、早期宫颈癌及妇科常见病发病情况,以及在宫颈癌筛查中存在的问题,并提出干预措施。方法对2013年3—12月浦口区江浦街道、泰山街道、石桥街道,参加宫颈癌筛查的35~64岁的已婚育龄妇女进行妇科检查、白带常规,薄层液基细胞学检查(thinprep cytologic test,TCT);对细胞学诊断阳性者,裸眼醋酸染色后或复方碘染色后肉眼观察结果异常,裸眼直观为宫颈溃疡,或可疑的宫颈组织有赘生现象进行阴道镜检查,并在阴道镜下进行病理活组织检查,以病理学诊断为金标准,对其结果进行分析,对异常情况进行随访。计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果在接受检查8 095例妇女中资料完整7 185例。7 185例妇女中TCT检查结果正常及炎性细胞反应7 003例,占97.47%,不典型鳞状上皮细胞(atypical squamous cellsof undetemined significance,ASCUS)及以上152例,占2.16%;患有妇科疾病总人数3395人,患病率47.25%;经病检确诊CIN 51例,患病率70.98/万;宫颈浸润癌4例,患病率5.57/万,CIN主要集中在35~49岁年龄段,宫颈浸润癌主要在55岁以后,生殖道感染2 855例,患病率39.74%,子宫肌瘤256例,患病率3.56%,卵巢囊肿232例,患病率3.22%,发病率最高的是生殖道感染,其中慢性宫颈炎1 308例,占生殖道感染45.81%。结论宫颈上皮内病变从低度到高度阳性涂片与病灶符合率逐渐增高,细胞学与组织学诊断具有一致性,TCT检查对宫颈癌前病变及早期宫颈癌筛查具有重要意义;薄层液基细胞学、阴道镜及阴道镜下组织活检三阶梯法,可达到早发现,早诊断,早治疗,降低宫颈癌发病率及病死率。
Objective To analyze and understand the cervical cancer screening data of 7 185 women in the three streets of Jiangpu Street, Taishan Street and Shiqiao in Pukou District and to understand and understand the incidence of cervical intraepithelial neoplasia, early cervical cancer and common gynecological diseases in Pukou District, Cervical cancer screening problems, and propose interventions. Methods Gynecological examination, routine leucorrhea and liquid-based liquid-based cytological examination of 35-64-year-old married women of childbearing age who participated in cervical cancer screening from March to December 2013 in Jiangpu Street, Taishan Street and Shiqiao Street, Pukou District, thinprep cytologic test, TCT). On the cytology diagnosis positive, naked eye acetic acid staining or compound iodine staining, the naked eye observation results abnormalities, naked eye visual acuity for cervical ulcer, or suspicious cervical neoplasms colposcopy, and in Colposcopy pathological biopsy to pathological diagnosis as the gold standard, the results were analyzed, the abnormal situation were followed up. Counting data using χ2 test, P <0.05 for the difference was statistically significant. Results Of the 8955 women examined, 7,185 were complete. Among 7 185 women, 7 003 cases (97.47%) had atypical squamous cells with undetected significance (ASCUS) and more than 152 cases (2.16%) with normal TCT and inflammatory cell reactions, 2.16% women with gynecological diseases The total number of 3395 people, the prevalence rate of 47.25%; diagnosed by CIN 51 cases of disease, the prevalence of 70.98 / million; 4 cases of invasive cervical cancer, the prevalence of 5.57 / million, CIN mainly concentrated in the 35 to 49 age group, Cervical invasive carcinoma mainly after 55 years old, 2 855 cases of genital tract infection, the prevalence of 39.74%, 256 cases of uterine fibroids, the prevalence of 3.56%, 232 cases of ovarian cysts, the prevalence of 3.22%, the highest incidence rate Genital tract infections, including chronic cervicitis 1 308 cases, accounting for 45.81% of reproductive tract infections. Conclusion The coincidence rate of cervical smear-grade lesions from low-grade to high-grade smears and lesions gradually increases, and cytology and histological diagnosis are consistent. TCT examination is of great significance for cervical precancerous lesions and early cervical cancer screening. Thin- Basic cytology, colposcopy and colposcopic biopsy three-step method, early detection can be achieved, early diagnosis and early treatment, reduce the incidence of cervical cancer and mortality.