新疆地区51226例不同民族妇女宫颈病变检查结果分析

目的通过对新疆汉族、维族及其他少数民族妇女宫颈液基细胞学检查,了解不同民族妇女宫颈病变发病情况。方法对2005年9月至2011年12月在新疆自治区人民医院妇产科门诊就诊及住院汉族、维族及其他少数民族患者行液基细胞学检查,共计51 226例,按照TBS分类标准分类。阳性结果为意义不明确的非典型鳞状上皮细胞(ASC-US)及以上病变。对于阳性结果及阴道镜下怀疑病变者进行组织活检,分析不同民族妇女宫颈感染病原情况、宫颈癌与癌前病变情况。结果维族妇女宫颈ASCUS及以上病变检出率(28.71%)显著高于汉族(23.75%)及其他民族(23.40%)(P<0.01),汉族与其他民族检出率差异无统计学意义(P>0.05)。维族妇女宫颈感染性病变的检出率(14.52%)也显著高于汉族(12.75%)及其他民族(8.70%)(P均<0.01),汉族与其他民族之间差异也均有统计学意义(P<0.01)。宫颈癌及癌前病变各年龄组检出结果显示,维族妇女总检出率为2.61%,汉族为1.72%,两民族差异有统计学意义(P<0.01)。汉维两民族在21～70岁之间检出率均随年龄增加而增加,其中21～60岁为高发分布年龄,且两民族在30岁以上各年龄组差异均有统计学意义(P<0.01或P<0.05);液基细胞学检查与病理诊断总符合率达78.71%。结论新疆维族妇女宫颈病变高发。汉、维族妇女宫颈病变随年龄增加而增加。应进一步加强宫颈液基细胞学筛查,以期早发现早治疗,降低发病率。

Analysis of cervical liquid-based cytological examination among different ethnic women in Xinjiang

Objective To investigate the characteristics of cervical lesions by cytological examination using liquid-based cytology（LBC） method among different ethnic women as Han,Uighur and other minority women in Xinjiang.Methods A total of 51 226 cervical examples were collected from both outpatients and inpatients in the Department of Gynecology and Obstetrics,People′s Hospital of Xinjiang Uighur Autonomous Region from September 2005 to December 2011,and examined for cervical lesions using LBC method.Samples were determined as positive if any atypical squamous cells of underdetermined significance（ASC-US） and above lesions were found based on the TBS standard.For those who had positive results or suspicious lesions by vaginal microscopy examination,the biopsy was taken for further examination.Cervical cancer,precancerous and infectious lesions were analyzed.Results The incidence of cervical ASCUS and above lesions among Uighur women（28.71%） was significantly higher than that in the Han（23.75%） and other minorities（23.40%）（P〈0.01） which were almost same.Also,the incidence of cervical infectious lesions among Uighur women was found to be the highest of 14.52%,which was significantly higher than that in Han（12.75%）（P〈0.01） and other ethnic groups（8.70%）（P〈0.01）.There was also a difference between the later two.The results of cervical cancer and precancerous lesion detected in all age groups showed that the overall positive rate in Uighur women was 2.61%（570/21875） and 1.72% in Han（415/24124） which was also statistically different（P〈0.01）. The incidence of cervical cancer and precancerous lesion was age-related which increased along with age between 21 to 70 years old in both Han and Uighur women with the highest incidence found in women aged 21 to 60 years,and also was different between each age group of the two ethic women over 30 years old（P〈0.01 or P〈0.05）.The analysis revealed that the coincidence rate between LBC test and pathological diagnosis was 78.7%（876/1113）.Conclusions The incidence of cervical lesions is high among Uighur women in Xinjiang,and is found to be up along with age in both Han and Uighur women.The cervical liquid-based cytological screening is an important way of reducing the morbidity of any kind of cervical lesions.