广东省龙川县1620例宫颈癌机会性筛查结果分析

目的研究龙川县接受宫颈癌机会性筛查的妇女宫颈癌及癌前病变的发病状况,并探讨液基细胞学检查（TCT）及阴道镜等在宫颈癌筛查和诊断中的临床意义及应用价值。方法收集分析龙川县人民医院2008年1月-2013年6月妇科门诊进行宫颈癌机会性筛查的1620例病例,对TCT阳性者进行阴道镜下宫颈活检及病理检查,确诊宫颈病变及宫颈癌。结果 1620例受检者中,TCT阳性为258例（15.9%）,活检证实为宫颈上皮内瘤变（CIN）者64例（3.95%）,宫颈浸润癌2例（0.12%）。在TCT阳性（258例）病例中,阴道镜检出异常者130例（50.4%）,其中活检结果为湿疣17例、CIN或浸润癌72例,阴道镜与活检诊断符合率为68.4%（89/130）。此外,不同年龄组对比发现宫颈癌发病率差异有显著性（P〈0.05）,定期筛查组（各机关事业单位及部分企业计划定期普查发现宫颈癌前病变及宫颈癌患者）阳性检出率显著低于非定期筛查组（随机抽查同期来龙川县人民医院就诊发现宫颈癌前病变及宫颈癌患者）（P〈0.05）。结论宫颈癌前病变及早期宫颈癌高发年龄在30~49岁,TCT结合阴道镜检查是较好的宫颈癌筛查手段之一。开展宫颈癌前病变定期筛查工作能显著降低宫颈癌的发生和发展机率。

Analysis of cervical cancer opportunistic screening results for 1620 cases in Longchuan county,Guangdong Province

Objective To understand the morbidity status of uterine cervix cancer （UCC） and precancerous lesions of women inLongchuan county and to evaluate the clinical significance andapplication value of thinprepcytologic test （TCT） and vaginoscopy incervical cancer screening. Methods From Jan 2008to Jun 2013, the cervical cancer screening was carried out in 1620 women ofLongchuan county. If the resuh of exfoliated cells examination was suspicious or abnormal, vaginoscopy should be done. ResultsAmong all 1620 screened cases, there was 258 TCT positive cases（ 15.9% ） ,64 cases（3.95% ） wereconfirmed cervical intraepithelialneoplasia （CIN）by biopsy, 2 cases （0. 12% ） were cervical carcinoma. Amog 258 cases of TCT positive patients, 130 cases（50. 4% ）were detected abnormal by colposcopy, of which there were 17 cases of condyloma and 72 cases of cancer invasion bycolposcopy respectively. The consistent rate of colposcopy and biopsy diagnostic is 68. 4% （ 89/130 ）. There was significantlydifference in incidence rates of UCC among different age groups （ P 〈 0.05 ）. Furthermore, the positive rate of the regular screeninggroup （women from enterprises, public institution and government agencies） was significantly （ P 〈 0.05 ） lower than that of non-regular screening group （ women from random screening）. Conclusions The incidence of UCC in age of 30 - 49 was greater thanother age gToups. TCT combined with colposcopy is a better means of screening for cervical cancer. Conduct periodic screening ofcervical lesions can significantly reduce the the incidence of UCC and development of cervical cancer.