液基细胞薄层涂片阴道镜对早期子宫颈癌筛查临床与流调应用研究

目的 :探讨液基细胞薄层涂片 ( TCT)、阴道镜合用对早期子宫颈癌及癌前病变筛查的可行性。方法 :以广东省东莞市长安医院妇科就诊的患者作为筛查人群 ,选择从未进行 TCT、阴道镜及 HPV等检查 ,且均有性生活和非孕期妇女 (年龄不限 )共计 2 5 14例 ,其中本地户籍 12 9例 ( 5 .1% ) ,外地户籍 2 385例 ( 94 .9% )。以病理组织学为金标准 ,结合 HPV- DNA分子生物学诊断技术 ,评价 TCT、阴道镜检查的诊断价值。结果 :该人群现患率 :HSIL (高度鳞状上皮内瘤变 )为 1.4 % ( 34/2 5 14 ) ;SCC(鳞状细胞癌 )为 0 .3% ( 7/ 2 5 14 ) ;平均年龄分别为 33.6和 38.1;人群平均初次性交年龄、性伴数、孕次、产次分别为 2 1.5、 3.2、 4 .8、 2 .3;从事宾馆娱乐美容业占 6 7.3%、家庭妇女占 12 .0 % ,3种方法的敏感度、特异度、阳性预测值、阴性预测值分别为 HPV (阳性≥ 1.0 pg/ ml) ( 0 .96 7,0 .84 4 ,0 .2 2 0 ,0 .998) ;TCT (≥ L SIL 为阳性 ) ( 0 .86 1,0 .95 9,0 .5 77,0 .993) ;阴道镜检查 (≥ CIN 为阳性 ) ( 0 .898,0 .6 89,0 .134,0 .993)。结论 :1该患病人群符合子宫颈癌及癌前病变的流行病学特点 ,因此 ,在开放地区开展早期子宫颈癌及癌前病变筛查有着重要的现实意义。 2 TCT制片效果优良 ,敏感度和特异?

The study of usage of fluid basement cell folium smear and vaginascopy on the clinical and epidemic investigation of early stage uterus neck cancer

Objective: To probe into the feasibility of fluid basement cell folium scrawl patch and vaginascopy used on the early stage uterus neck cancer investigation and precancer lesion epidemic investigation Methods: Gynecology patients of Chang'an hospital of Dongguan city,Guangdong province are detection group , select no TCT ,vaginascopy and HPV etc , have sexual life and not pregnant period, they are 2 514 cases, resident is 129(5 1%), the other places resident is 2 385(94 9%) Pathohistoloty is golden standard, to determine the diagnosis value of TCT,vaginascopy Results:High scaly inner dermal carcinoma lesion(HSIL) is 1 4%(34/2514),scaly cell carcinoma is 0 3%(7/2514),average age are 33 6 and 38 1 separately , the average age of primary sexual intercourse ,sexual partners numbers, pregnant numbers , obstetrics numbers are 21 5,3 2,4 8,2 3 separately Those working for restaurant ,enjoyment , beauty professions are 67 3%,home women are 12 0%, the three methods of sensitive degree, special degree, positive predictive value, negative predictive value are HPV(positive>1 0 pg/ml,0 967,0 844,0 220,0 998);TCT(>LSIL is positive,0 861,0 959,0 577,0 993);vaginascopy (>CIN I is positive,0 898,0 689,0 134,0 993) Conclusion: (1)This group accord with the epidemic feature of uterus neck cancer and precancer lesion, so developing early stage uterus neck cancer and precancer lesion detection in the open area has important reality value (2)TCT effect is good ,sensitive degree and special degree are ideal vaginascopy is cheap and easy to operate , combining with HPV and pathology detection can promote the property of diagnosis, meat the demands of early stage uterus neck cancer and precancer lesion investigation, are suitable to be routine check methods in primary hospital of the opening areas