宫颈糜烂高危因素的病例对照研究

目的:探讨人群宫颈糜烂发生的相关危险因素。方法:采用病例对照的研究方法,对141例宫颈糜烂患者和137例宫颈光滑者对照进行年龄、生殖道病原微生物、婚育史、性行为等因素研究。结果:在单因素分析的基础上进行多元Logistic回归分析,最终引入回归方程的变量为年龄、首次性交年龄、分娩方式、产次、HPV感染,而首次发生性行为年龄、结婚和孕育年龄、孕产次等生殖因素,与宫颈糜烂发生的危险性呈剂量-反应关系。结论:年龄、首次发生性行为年龄小、HPV感染和孕产次是宫颈糜烂发生的高危因素。     

宫颈癌及癌前病变危险因素的病例对照研究

目的探讨石嘴山市惠农区宫颈癌及癌前病变发病的相关危险因素,为现阶段宫颈癌的防制工作提供依据。方法采用1∶1的病例-对照研究方法,用统一的调查问卷对确诊为宫颈癌及癌前病变的92例患者和94例同期筛查中最终确诊为非患者的妇女进行调查。结果单因素分析结果显示,感染HPV、既往妇科疾病史、阴道不规则出血、孕次数多和产次数多是宫颈癌及癌前病变的危险因素;高文化程度、家庭月收入高、居住在城市、首次性生活(性行为)年龄晚、性生活前/后冲洗外阴、初孕年龄晚、初产年龄晚、丈夫性生活前进行冲洗是保护因素;多因素分析结果表明,HPV感染(OR=3.521)、产次数(OR=1.836)和阴道不规则出血(OR=2.217)为危险因素。结论宫颈癌及癌前病变的发生受多种因素的影响,积极控制相关危险因素,加强对高危人群的监测,有助于预防宫颈癌及癌前病变的发生。     

宫颈癌危险因素的1:1病例对照研究

目的 探讨宫颈癌发病的危险因素,为监测和预防提供科学依据.方法 收集2013-2019年西丰县开展的宫颈癌筛查活动检出的宫颈癌患者107例作为病例组,并选择同时期排除宫颈癌诊断的女性107例作为对照组.采用病例对照研究方法,对宫颈癌发病的危险因素进行研究.结果 单因素分析显示,居住地、人乳头瘤病毒(HPV)感染、既往妇科疾病、首次性行为年龄、性行为卫生、初孕年龄、初产年龄、孕次数和产次数是宫颈癌患病的危险因素.多因素分析显示,HPV感染、既往妇科疾病史和产次数是宫颈癌患病的危险因素.结论 宫颈癌发生受多种因素影响,积极控制相关危险因素,加强对高危人群监测,有助于预防宫颈癌发生.     

宫颈癌住院患者临床特点及影响因素

目的宫颈癌严重威胁女性生命健康,本研究旨在探讨宫颈癌住院患者的临床特点及影响因素。方法选择大连市妇幼保健院2014-05-10-2019-05-20收治的500例宫颈癌患者作为病例组,另选取同期行体检的500名非宫颈癌检查者作为对照组。通过问卷调查收集年龄、孕次、产次、吸烟、避孕方法、家族相关遗传病史和首次性行为时间等资料,并进行分析。结果 500例宫颈癌患者中,临床分期:Ⅰ期209例,ⅡA期291例;病理类型:鳞癌412例,腺癌88例;肿瘤直径:<2cm 221例,≥2cm 279例;脉管累及:有162例,无338例;淋巴转移332例。单因素分析结果显示,两组在孕次(χ~2=38.440,P<0.001)、吸烟(χ~2=58.080,P<0.001)、避孕方法(χ~2=69.370,P<0.001)、家族相关遗传病史(χ~2=82.850,P<0.001)和首次性行为年龄(χ~2=97.320,P<0.001)等方面比较,差异有统计学意义。多因素分析结果显示,宫颈癌的危险因素为吸烟史(OR=1.725,95%CI为1.161～2.562,P=0.007)、服用避孕药(OR=2.255,95%CI为1.275～3.988,P=0.005)、有家族相关遗传病史(OR=2.782,95%CI为1.597～4.844,P<0.001)、孕次≥3次(OR=1.958,95%CI为1.360～2.820,P<0.001)和首次性行为年龄≤20岁(OR=3.370,95%CI为1.566～7.253,P=0.002)。结论宫颈癌患者的病理特点为临床分期较晚,鳞癌比例较高,多无脉管累及,且淋巴结转移率较高;孕次、吸烟、避孕方法、家族相关遗传病史和首次性行为年龄为主要影响因素。     

宫颈癌相关影响因素病例对照研究

目的 了解宫颈癌的相关影响因素,为预防宫颈癌发病提供科学依据.方法 采用以医院为基础病例对照研究方法对2007年9月-2010年6月在福建省厦门市妇幼保健院、厦门市第一医院和厦门市中医院就诊的112例宫颈癌患者及同期就诊的200例其他疾病女性患者进行宫颈癌相关影响因素问卷调查并检测血中维生素B12及叶酸含量.结果 单因素Logistic回归分析结果表明,首次性生活年龄(OR=0.659)、首次生育年龄[OR=0.715)、叶酸含量(OR=0.386)、维生素B12含量(OR=0.661)、经常饮茶(OR=0.596)、被动吸烟(OR=1.738)、性行为时注意卫生(OR=0.483)、分娩次数(OR=1.904)是宫颈癌发病的相关影响因素;多因素Logistic回归分析结果表明,分娩次数＞2次和被动吸烟是宫颈癌发病的危险因素;叶酸含量≥10 nmol/L、经常饮茶和性生活时注意卫生是宫颈癌发病的保护因素.结论 有多次分娩史和被动吸烟的妇女患宫颈癌的危险性较大;性行为时注意卫生、经常饮茶、补充叶酸可预防宫颈癌的发生.     

济南市女性宫颈细胞学检查及HPV检测结果分析

目的 分析山东省济南市女性宫颈细胞学检查及HPV检测结果,为早发现、早诊治及预防宫颈疾病提供参考依据。方法 以2019年10月31日至2020年12月31日进行宫颈癌筛查的山东省济南市辖区成年女性作为研究对象,所有研究对象接受问卷调查、病史询问并签署知情告知书后采用巴氏涂片法进行细胞学检查及人乳头瘤病毒（HPV）检测,对于细胞学异常及高危型HPV阳性者进一步行阴道镜和病理学检查,采用单、多因素方法分析宫颈细胞学异常及HPV异常的影响因素。结果 最终10 176名女性纳入研究,宫颈细胞学异常319例、异常率3.13%,HPV异常1 025例、异常率10.07%。不同年龄、初次性生活年龄、产次、不良孕产史的女性宫颈细胞学异常率差异有统计学意义（P<0.05或P<0.01）,多因素Logistic回归显示年龄（OR=1.430）、产次（OR=2.330）、不良孕产史（OR=3.086）是女性宫颈细胞学异常的相关因素。不同年龄、不良孕产史、宫颈癌家族史、妇科疾病史、定期妇科检查的女性HPV异常率差异有统计学意义（P<0.05或P<0.01）,多因素Logistic回归分析年龄（OR=1.342）、不良孕产史（OR=2.735）、宫颈癌家族史（OR=2.293）、妇科疾病史（OR=1.694）是女性HPV异常的相关因素。宫颈细胞学异常且HPV阳性者宫颈上皮瘤变检出率更高。结论 济南市女性宫颈细胞学检查及HPV检测异常率均较高,其受到多因素影响,应针对影响因素加强相关人群健康宣教,提高宫颈癌防范意识,预防宫颈癌。     

乌鲁木齐地区汉族和维吾尔族个体因素与宫颈癌发病的对比分析

目的 探讨本地区汉族和维吾尔族宫颈癌发病的相关危险因素.方法 选择乌鲁木齐市三家医院自1995～2007年就诊的汉族和维吾尔族宫颈癌患者共168例,采用回顾性病例对照研究.调查患者个人、家庭、生活习惯、职业环境因素,现患病史、月经史、婚育史及既往史等.结果 年龄、月经初潮年龄在本地区汉族和维吾尔族宫颈癌发病率无明显差异.性生活开始年龄、初孕年龄、个人或配偶烟龄在本地区汉族和维吾尔族宫颈癌发病率的差异有统计学意义.结论 重视个体行为的高危因素、定期进行妇科体检,为预防宫颈癌的有效方法之一.     

宫颈癌危险因素调查分析

目的探讨汕头市宫颈癌发病危险因素,为宫颈癌的早期防治提供科学依据和措施。方法采用以医院为基础的1∶2病例对照研究方法,选择汕头市3所市级医院164例宫颈癌患者作为病例组,同期其他非肿瘤患者328例作为对照,对其婚育史、避孕史、HPV感染情况等进行调查,应用条件Logistic回归分析筛选宫颈癌发病危险因素。结果在单因素Logistic回归分析的基础上,HPV感染、初次分娩年龄、初婚年龄、怀孕次数、人工流产次数、初次性交年龄、吸烟、丈夫是否清洁包皮垢、宫颈炎、生产次数、及肿瘤家族史等因素被引入回归模型,以上因素均与宫颈癌发生有密切关系;经Logistic多因素回归分析后获得的前4位因素为:HPV感染、生产次数、人工流产次数、首次性交年龄等。结论 HPV感染是汕头市宫颈癌发生的主要危险因素,生产次数多、人工流产次数多、首次发生性行为的年龄小可增加宫颈癌发生的危险;提出宫颈癌预防工作应提高妇女生殖健康意识,同时应提高男性对宫颈癌防治的参与意识,宣传计生政策,加强各种男性避孕措施的使用,减少妇女宫颈炎及人工流产的发生率,此外,在普查中应常规增加阴道镜检查,行宫颈取材HPV检测与传统巴氏涂片结合,必要时使用先进的细胞学检测方法,提高宫颈癌前病变的检出率,达到早期筛查,早期诊断。     

宫颈糜烂危险因素的病例对照研究

目的探讨妇女宫颈糜烂发生的相关因素。方法采用病例对照研究方法,病例组为妇科门诊宫颈糜烂患者150例,对照组为来自同一医院的150名无宫颈糜烂病人,收集两组婚孕情况、性生活及生育史、病原微生物感染情况等信息,对宫颈糜烂可能的危险因素进行单因素和多因素logistic回归分析。结果单因素分析显示,各年龄组间31岁~35岁组宫颈中、重度糜烂比例明显高于其他年龄组,差异有统计学意义(P<0.05)。病例组比对照组HPV感染阳性率高,差异有统计学意义(P<0.05)。多因素分析证实,结婚年龄、首次发生性行为年龄、分娩方式、产次、HPV感染与宫颈糜烂发生显著相关,OR值(95%C I)分别为0.51(0.31~0.83)、0.50(0.31~0.82)、0.32(0.16~0.65)、2.29(1.31~4.01)、2.89(1.21~6.90)。结论首次性交年龄、婚孕年龄越小,孕、产次越多,HPV感染率越高的人群,发生宫颈糜烂的危险性越大。     

72例盆底器官脱垂疾病的临床分析

目的:分析POP患者的相关因素、临床现状,旨在提高对该病的认识以及预防和诊疗水平。方法:采用描述性分析的方法对72例于2004年1月～2008年12月因POP首次在吉林大学第一医院妇产科手术的患者进行回顾性对照研究,分析年龄、体重指数、绝经史、生育史(妊娠次数、经产次数)、便秘、慢性咳嗽、主要临床诊断及其他临床诊断等资料与POP的关系,并分析POP分度不同的临床差异(术前准备时间、术后住院时间、住院费用)。结果:POP具有年龄集中趋势,多发生于≥50岁的中老年绝经妇女。体重超重、妊娠次数≥3次、经产次数≥3次的妇女罹患POP可能性增高。结论:目前POP的诊断主要依赖于询问病史和妇科检查,使用影像学辅助诊断较少,治疗以手术治疗为主,而手术术式的选择主要取决于患者年龄、有无生育要求等。盆腔器宫脱垂疾病重在预防。     

Co-factors related to the causal relationship between human papillomavirus and invasive cervical cancer in Honduras

BACKGROUND: A case-control study was conducted in Honduras to identify co-factors in the carcinogenic pathway by which human papillomavirus (HPV) causes invasive cervical cancer. METHODS: Ninety-nine cases aged 23-65 (median 47) years participated. Two controls were matched to each case by age and clinic where they first presented for cytological screening; controls had no cervical abnormalities. Information on risk factors was obtained by personal interviews in the clinics regarding sociodemographic, reproductive and behavioral characteristics. Human papillomavirus was detected in cervical scrapes by general primer-mediated polymerase chain reaction (PCR) followed by sequence analysis to identify the different types present. RESULTS: All cases had squamous cell tumours and most were FIGO (International Federation of Gynecologists and Obstetricians) class II or higher; HPV was strongly associated with cervical cancer (odds ratio [OR] = 7.66, 95% CI : 3.88-15.1). Among HPV-positive women, dose-response relationships were observed for education, age at first intercourse and exposure to wood smoke that persisted after adjustment for previous screening. Among HPV-negative women, the number of sexual partners and parity were associated with cervical cancer. The protective effect of previous cytological screening operated independently of HPV. CONCLUSIONS: Our findings speak for the powerful role that both primary and secondary education plays in fostering a lifestyle that reduces the risk of invasive cervical cancer. The data suggest that important elements of such a lifestyle include later age at first sexual intercourse, a limited number of pregnancies, greater likelihood of undergoing cytological screening and reduced exposure to carcinogens in the household environment.     

Condyloma and intraepithelial neoplasia of the uterine cervix: a case-control study

Cervical condyloma and cervical intraepithelial neoplasia are related to human papillomavirus infections, some of which may be involved in the etiology of cancer of the uterine cervix. This case-control study was designed to assess the relation of age at first sexual intercourse, number of sexual partners, and cigarette smoking to the risk of cervical condyloma and cervical intraepithelial neoplasia. Cases and controls were premenopausal women under age 50 years who had been referred for examination at the Colposcopy Clinic of Saint-Sacrement Hospital in Quebec from 1982 to 1985. These were 136 cases of histologically confirmed cervical condyloma and 247 cases of cervical intraepithelial neoplasia. The 137 controls were women without anogenital condyloma, dysplasia, or carcinoma. Information on personal characteristics and exposures of subjects was obtained by interview. Associations observed with age at first intercourse were different for condyloma and cervical intraepithelial neoplasia. Relative risk of condyloma varied little with age at first intercourse. In contrast, relative risk of cervical intraepithelial neoplasia increased as age at first intercourse decreased. For the two types of lesions, relative risk was elevated among women with more than one sexual partner and increased steadily with increasing number of cigarettes smoked per day. The association with cigarette smoking was, however, somewhat stronger for cervical intraepithelial neoplasia.     

中国妇女宫颈癌行为危险因素的Meta分析

目的 探讨中国妇女宫颈癌发病的行为危险因素.方法 应用Revman 5.0对国内已发表的33篇有关宫颈癌的病例对照研究进行定量综合分析.结果 各因素合并OR值（95％CI）分别为：性交年龄3.33（2.57 ～ 4.31）,怀孕年龄2.00（1.28 ～ 3.12）,生育年龄1.57（1.01 ～ 2.45）,怀孕次数2.37（1.87 ～ 3.00）,流产次数2.98（1.96 ～4.53）,生育次数2.79（2.26～3.44）,性伴侣数3.38（2.33 ～4.90）,结婚次数2.98（1.68 ～ 5.27）,应用避孕套0.32（0.20 ～ 0.49）,无任何避孕措施2.16（1.07 ～4.34）,性生活前清洗阴道0.55（0.34～0.87）,吸烟2.50（1.74～3.59）,被动吸烟史2.84（1.84 ～ 4.39）,喝茶0.36（0.27 ～ 0.50）及从事脑力劳动0.35（0.17 ～ 0.72）.结论 首次性交、怀孕、生育年龄过早、怀孕、流产、生育、结婚次数、性伴侣数过多、无任何避孕措施及吸烟和被动吸烟是宫颈癌发病的行为危险因素;应用避孕套、性生活前清洗阴道、喝茶和从事脑力劳动是宫颈癌发病的行为保护因素.     

山西省襄垣县宫颈癌危险因素分析

目的：在宫颈癌高发区调查其危险因素,为现阶段宫颈癌的防治工作提供依据。方法：在宫颈癌高发区山西省襄垣县,对1997年妇女采用6种宫颈癌检查方法筛查后,进行问卷调查,卷卷内容包括：基本信息,月经婚孕史,性行为及卫生习惯,避孕史,既往疾病和肿瘤家族史等,进行高危型人乳头瘤病毒（HPV）检测,病理学诊断为宫颈高度鳞状上皮病变以上者86例,非癌及非鳞状上皮病变者共1784例作为对照.结果：高危型HPV感染率为20．8％（415／1997）,病例组HPV感染率为97．7％,而对照组为14．2％,单因素分析后,具有显著统计意义的变量有：高危型HPV感染,初次性交年龄,流产史,性伴侣数,怀孕治疗史及肿瘤家族史等。logistic回归分析结果表明,高危型HPV感染,性伴侣数和肿瘤家族史与宫颈癌的发生呈显著关联,此外,HPV感染与男,女婚外性行为均有显著的统计学联系,且随性伴侣数呈趋势性增高,结论：襄垣县妇女子宫颈癌高发的主要危险因素是高危型HPV感染。HPV感染与该地区性生活,月经期及产褥期卫生不洁有直接关联。     

#3 Parity,age at first birth,and risk of invasive cervical cancer: Meta-analyses

PURPOSE: The roles of parity and age at first birth as risk factors for cervical cancer remain unclear, although several studies in different populations have examined this question. We performed meta-analyses to predict relative risk of invasive cervical cancer as functions of parity and of age at first birth by fitting a variety of models.METHODS: We fit models relating the logarithm of relative risk for cervical cancer to parity and to age at first birth. Parity models were based on parity-specific relative risk estimates from 21 studies published between 1985 and 2001. Age at first birth models were based on corresponding data from 11 studies published during the same time period. Some models included covariates indicating whether individual studies adjusted for human papilloma virus (HPV) status, number of sex partners, age at first birth (parity models only), and/or parity (age at first birth models only).RESULTS: Relative risk for cervical cancer was found to increase with parity, at a declining rate (i.e., the greatest increase in risk was between parity 0–1, with consistently smaller increases thereafter). Relative risk for first birth at ages ⩾17 was significantly lower than relative risk for first birth at age 13, but no significant relationship was found between relative risk and age at first birth for first birth at ages ⩾17. Overall, indicators of whether studies adjusted for covariates were unable to explain the large variations among study results.CONCLUSION: Risk of invasive cervical cancer was associated with increasing parity, with the greatest increase in risk with the first birth. Risk was decreased for first birth at age 17 compared to 13; for first birth at ages ⩾17, we were unable to derive a quantitative relationship between age at first birth and relative risk for cervical cancer.     

Relative and attributable risk for cervical cancer: a comparative study in the United States and Italy

The attributable risk for invasive cervical cancer in the US and Italian populations has been estimated in relation to main 'aetiological' factors (number of sexual partners, age at first intercourse, parity, oral contraceptive use and smoking) and history of Pap smear using data from two case-control studies conducted in the US (466 cases and 788 controls) and Italy (528 cases and 456 controls). The risk of cervical cancer increased in both studies with multiple sexual partners, decreasing age at first intercourse, higher parity, oral contraceptive use and smoking. Levels of exposure to various risk factors were markedly different in the two countries (ie number of sexual partners, frequency of oral contraceptive use and smoking were greater in the US). Multiple Pap smears and a short interval since last Pap smear strongly reduced risk of cervical cancer in both populations, although screening was much more widespread in the US study population, with only 9% of controls reporting no previous smear versus 38% of the Italian control series. The combined population attributable risk for the five 'aetiological' risk factors was slightly greater in the US study (76%) than in the Italian one (69%), chiefly because of a higher prevalence of exposure to sexual factors in US study women. A substantially larger proportion of Italian cases were due in part to deficiency in screening (46% in US and 84% in Italy). Thus, further inclusion of the effect of screening programmes (number of Pap smears and time since last Pap) led to an overall proportion of cases attributable to the examined risk factors of 87% in the US and 95% in Italy.     

高危型人乳头瘤病毒感染相关危险因素分析

目的探讨宫颈高危人乳头瘤病毒(HPV)感染的危险因素。方法选取郑州大学第三附属医院2009年9月～2011年3月间行高危型HPV(HR-HPV)筛查的门诊或病房患者阳性病例306例,27例HPV-DNA阴性作为对照组,用杂交捕获二代法(HC2)检测HPV-DNA,所有患者均填写HPV感染相关危险因素调查表,单因素和多因素非条件Logistic回归分析的方法对调查信息进行分析。结果经单因素非条件Logistic回归分析,受教育程度,家庭人均收入,第一次结婚年龄、被动吸烟、曾经怀孕、人工流产、使用避孕套、第一次性生活年龄、性伴侣数与HPV感染存在相关性(P﹤0.05)。经多因素非条件Logistic回归分析,家庭人均收入,被动吸烟,使用避孕套,第一次性生活年龄有关(P﹤0.05)。结论被动吸烟、人工流产、性伴侣数多是HPV感染的危险因素(OR﹥1),受教育程度高、经济收入多、使用避孕套、第一次性生活年龄大是HPV感染的保护因素(OR﹤1)。因此应加强对HPV易感人群的卫生宣教与管理,从而预防宫颈癌的发生。     

广东省恩平市２０１６年寨卡病毒病疫情流行病学分析

摘要：目的　对广东省恩平市２０１６年寨卡疫情防控工作进行梳理和分析,为寨卡等虫媒传染病的应对提 供新的思路。方法　通过“中国疾病预防控制系统”、恩平市２０１６年制定的寨卡防控的相关文件、恩平市 疾控中心《寨卡病毒病防控工作简报》获取相关信息,并通过“广东省病媒生物监测信息平台”获得蚊媒 监测数据。采用Ｅｘｃｅｌ对数据信息进行汇总整理和描述性分析。结果　广东省２０１６年２月１５日至６月５日 共报告输入性病例１３例,均由南美国家输入,无本地感染病例报告。广东省恩平市在２月１９日立即建立 联防联控机制,制定６个工作方案;在定点收治医院对全部病例开展病例管理;２月１１日至１１月３０日恩 平对１１８４名归国人员进行追踪随访,对７８２人进行采样筛查,发现７ 例寨卡病例和３ 名隐性感染者;通 过蚊媒控制,将全年大部分布雷图指数（ＢＩ）和诱蚊诱卵器指数（ＭＯＩ）控制在１０以下水平。结论　广东 省２０１６年通过采取综合防控措施,阻止了本地病例的发生,防控措施切实有效。 关键词：寨卡病毒病;病例管理;隐形感染者;健康随访;蚊媒控制 中图分类号：Ｒ１８３．５　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１９）０１ ００３７ ０５