新疆维吾尔族妇女宫颈癌筛查方法横断面比较研究

目的]探讨适合新疆维吾尔族妇女宫颈癌的筛查方法。方法]于2006～2007年采用整群抽样方法,选择新疆维吾尔族妇女883名,采用自我采样HPV检测,液基细胞学检查,医生采样HPV检测,肉眼筛查(VIA)进行宫颈癌筛查。分析和比较不同筛查方法的灵敏度、特异度、阳性预测值、阴性预测值。结果]医师采样HPV检测的灵敏度和特异度均为最高(P<0.01),自我采样的灵敏度与细胞学检查相似(P>0.05),但自我采样HPV检测的特异度高于细胞学检查(P<0.01),与医生采样HPV检测相似(P>0.05)。肉眼筛查的灵敏度和特异度为最低。结论]新疆维吾尔族妇女的宫颈癌筛查方案应首选医生采样HPV检测,自我采样HPV检测是比较适合于新疆民族地区妇女的方案,在偏远和缺少设备的地区,肉眼筛查也是一种可行的筛查方法。

A Cross-section Population Study on Different Cervical Cancer Screening Methods in Uygur Women of Xinjiang

Purpose] To investigate the best cervical cancer screening methods adapted to Uygur women in Xinjiang. Methods] Eight hundred eighty-three Uygur women in Xinjiang from 2006 to 2007 selected with entire cluster sampling method, accepted self-sampling for HPV test, liquidbased cytology, physician-sampling for HPV test, and Visual Inspection with acetic acid （VIA）. All of the data were analyzed for sensitivity, specificity, positive predictive value, negative predictive value of different cervical cancer screening methods. Results] The sensitivity and specificity of physicians sampling HPV detection was the highest of all cervical cancer screening methods （P〈0.01）. The sensitivity of self-sampling for HPV test was similar to cytology （P〉0.05）, but the specificity of self-sampling HPV test was higher than that of cytology （P〈0.01）, and was similar to physician-sampling HPV test （P〉0.05）. The sensitivity and specificity of VIA were both the lowest in all the methods. Conclusionsl For the Uygur women in Xinjiang, the best cervical cancer screening methods is physician-sampling HPV test. And the self-sampling HPV test is more suitable for Uygur women in Xinjiang. In the condition of lack of health care facilities, VIA is also a kind of feasi- ble screening method.