大同矿区宫颈癌发病相关因素调查分析

目的探讨大同矿区宫颈癌发病相关因素,为采取有针对性的预防措施提供客观、科学的决策依据,进一步降低宫颈癌的发病率和死亡率。方法选取2011年12月-2014年12月经大同煤矿集团公司总医院病理科确诊的100例宫颈癌患者和300例按年龄和就诊时间匹配的健康对照进行问卷调查,包括一般情况、饮食与生活方式、月经婚育史、激素使用、既往病史与家族史和妇女病普查知识等因素的调查。结果大同矿区女性宫颈癌发病年龄平均45岁,多因素分析显示采用避孕措施是宫颈癌的保护因素,子宫颈癌家族史、乳腺癌家族史、既往滴虫性阴道炎和吸烟为宫颈癌的高危因素。结论大同矿区宫颈癌高发区位于南郊棚户区,加强对该区高危人群的筛查工作可以有效降低大同矿区宫颈癌发病率。     

729例卒中高危人群颈动脉超声筛查结果分析

目的:本文分析卒中高危人群颈动脉超声筛查结果。方法:选择本院在2018年7月~2019年7月接收的卒中高危患者729例,对其进行了颈动脉超声筛查,随后总结卒中高危人群不同性别危险因素、卒中高危人群不同年龄危险因素、卒中高危人群不同年龄IMT增厚情况。结果:卒中高危人群不同性别危险因素中,女性年龄、高血压、心房颤动、血脂异常、糖尿病、缺少体育锻炼、超重、有卒中家族史、短暂性脑缺血、既往卒中危险因素高于男性,男性吸烟危险因素高于女性;卒中高危人群不同年龄危险因素中,年龄越大患者的超声异常率越高,≥70岁患者的超声异常率最高;卒中高危人群不同年龄IMT增厚情况中,年龄越大患者的IMT增厚情况越高,≥70岁患者的IMT增厚情况最高。结论:卒中高危人群颈动脉超声筛查结果显示,超声异常率和IMT增厚情况均和卒中高危人群的年龄相关。     

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.     

武汉市20余万农村妇女宫颈癌和乳腺癌筛查情况分析

目的:了解武汉市农村妇女宫颈癌和乳腺癌患病情况及相关因素。方法:采用液基薄层细胞学技术(TCT)和DNA倍体定量分析技术检测宫颈脱落细胞,初筛阳性者采用阴道镜下取宫颈活体组织进行病理检查;采用触诊及彩色多普勒超声进行乳腺检查,初筛阳性者行钼靶摄片检查或乳腺穿刺行细胞学检查。对所有初筛阳性者进行问卷调查,了解一般人口学情况、环境因素、遗传因素、既往史及现病史、女性个人健康史、生活习惯及饮食习惯以及社会心理因素等因素。结果:全市共对202 067例妇女进行"两癌"筛查,共检出宫颈癌前病变770例、宫颈癌33例(27.13/10万),乳腺癌32例(23.85/10万)。对"两癌"影响因素分析提示:HPV感染、宫颈癌家族史、基础妇科疾病、初次性行为年龄早是宫颈癌前病变发生的危险因素;HPV感染、初次生育年龄早以及经历不良生活事件是宫颈癌发生的危险因素;初婚年龄晚、文化程度低、经常使用电脑或电视机、有癌症家族史、流产及引产史是乳腺癌发生的危险因素。结论:通过开展宫颈癌和乳腺癌筛查,起到早发现、早诊断、早治疗的作用,对降低宫颈癌和乳腺癌的发病率及死亡率具有重要的意义。将来需根据"两癌"高危因素进一步加强针对性的健康教育工作,完善"两癌"筛查与随访制度,保障妇女的生殖健康。     

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.     

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。     

海淀区宫颈癌发病相关危险因素分析

目的:研究宫颈癌发病的相关危险因素。方法:收集2001~2002年海淀区户籍在北京各大医院就诊并经病理证实为宫颈癌的患者临床资料77例。按照1∶3病例对照配比原则,对照组进行系统的妇科体检,选择在个人、家庭、生活习惯、职业环境、现患史及既往史等进行条件单因素logistic分析。结果:对照组体检确诊宫颈癌一例,子宫内膜癌一例,从对照组剔除,重新选对照,单因素logistic分析显示,结婚次数、怀孕次数、白带多、白带异味、阴道排液、阴道不规则出血为宫颈癌的高危因素。结论:重视高危因素,定期进行妇科体检,为预防宫颈癌的有效方法。     

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。     

江西省修水县宫颈癌危险因素分析

目的:在子宫颈癌高发区江西修水地区调查其危险因素,为现阶段宫颈癌的防治工作提供依据。方法:选取30～49岁的1907例已婚妇女为研究对象,签署知情同意书后,进行问卷调查,问卷内容包括: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。病例组是经病理证实为宫颈癌及中高度鳞状上皮病变者,共86例;对照组是经病理诊断正常者,共1737例。结果:该人群高危型HPV DNA总检出率为18.7%。病例组HPV感染率为94.2%,对照组HPV感染率为11.8%。单因素分析显示,高危型HPV感染、饮用井水、婚姻次数、性伴侣数及宫颈炎病史等5个因素具有显著意义。多元Logistic回归分析后,高危型HPV感染(OR=154.5)和饮用井水(OR=2.85)具有显著意义。结论:生殖道高危型HPV感染是当地宫颈癌及宫颈上皮内瘤变流行的主要危险因素,提示宫颈癌的防治重点应放在防止HPV感染、对HPV感染的筛查和密切监测已感染高危型HPV的对象上。当地井水的水质情况与宫颈癌的关系还有待进一步研究。HPV DNA检测是一种较实用的宫颈癌初筛手段。     

建德地区166例30～70岁女性乳腺癌发病影响因素调查

目的分析建德地区30～70岁女性乳腺癌发病影响因素,为女性乳腺癌防治提供参考。方法选取2017年7月-2019年4月在该院就诊且经组织病理检查证实为乳腺癌的166例患者为观察组,另选取同期在该院健康体检的正常健康女性166例为对照组。调查两组研究对象基本资料,包括乳腺癌家族史、生育史、既往月经状况、服药情况及乳腺疾病状况等。结果两组研究对象在生育史、初产年龄、哺乳史、流产史、初潮年龄、自然绝经年龄、行经时间、家族史、使用激素类药物、既往乳腺疾病史方面比较,差异均有统计学意义(均P0. 05)。经调整年龄和绝经状态等因素后,多因素分析结果显示,乳腺癌家族史、服用激素类药物、既往存在乳腺疾病史及初潮初产间隔时间长是女性发生乳腺癌的高危因素(均P0. 05);而生育史、哺乳史及初潮年龄晚是女性发生乳腺癌的保护性因素(均P0. 05)。以绝经状态进行分析,绝经女性中,初潮年龄晚、有生育史及无流产史是女性发生乳腺癌的保护性因素(均P0. 05);未绝经女性中,初潮初产间隔时间超过17年是发生乳腺癌的高危因素(P0. 05)。结论女性发生乳腺癌的影响因素较多,包括乳腺癌家族史、既往存在乳腺疾病史和初潮年龄等,生育史和哺乳史是有效保护女性的重要因素,因此可加强宣教,鼓励女性尽早母乳喂养,降低乳腺癌发病率,同时做好健康体检,做到早发现、早治疗。     

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     

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.     

Cervical Cancer Risk as a Predictor of Pap Smear Use in Rural North Carolina

Risk for invasive cervical cancer is reported to be higher in rural areas than urban ones, and cervical cancer-related mortality is higher in rural women due to poorer utilization of preventive services and subsequent presentation at late stages of the disease. This cross-sectional study examined the relationship between prevalence of risk factors for cervical cancer and the degree of compliance with risk-appropriate screening guidelines for cervical cancer. Secondary data were analyzed for 614 women from Robeson County, NC, aged 40 and older, and of mainly rural and low socioeconomic status. High-risk status was determined by the presence of any of the following five risk factors: a history of more than two sexual partners, age at first sexual intercourse under 18 years, history of sexually transmitted disease, history of sexually transmitted disease in sexual partner(s), and smoking. Low-risk status was the absence of all factors. A high-risk participant was considered compliant if she had had at least three Pap smears in the 3 years prior to the interview, while a low-risk participant was considered compliant if she had had at least one Pap smear within the previous 3 years. Overall, 82% of the participants were at high risk for cervical cancer. However, only 41% of all participants were compliant with the risk-appropriate screening guidelines. Low-risk status was significantly associated with compliance with cervical cancer screening guidelines (adjusted OR = 6.7; 95% CI = 3.7 to 11.1, p = .0001). Findings in this study population suggest rural women at high risk for cervical cancer are less likely to be compliant with appropriate Pap smear screening guidelines, indicating the need to target educational programs.     

宫颈癌危险因素病例对照研究

目的 探讨宫颈癌高发区的相关危险因素。方法 采用以住院患者为基础的病例对照研究方法，对129名经病理确诊的宫颈癌患者和143例非肿瘤病人对照进行有关月经、婚育史、性行为与避孕史、个人卫生习惯等因素的调查。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家庭经济收入、首次性交年龄、洗澡设施、妇科病史、产次和绝经，而结婚年龄、首次发生性行为和孕育年龄、孕产次等生殖因素，则与宫颈癌发生的危险性呈剂量一反应关系。结论 经济收入低、首次发生性行为的年龄小、既往有妇科病史、孕产次多可增加宫颈癌发生的危险性，特别值得注意的是洗澡和清洗阴部少等不洁卫生习惯可能是导致当地该病高发的原因之一，绝经后妇女宫颈癌发生的危险性较低。     

上海市徐汇区女性肺癌病例对照调查

All the 57 female lung cancer patients in Xu-Hui District, Shanghai discovered during 1985 were used as subjects of this study, each was matched with 2 of her near neighbours of same sex and within 5 years of age difference. Smoking, chronic bronchitis, pulmonary tuberculosis and family history of tumour were found to be related with lung cancer in single variable analysis. Upon stratification, smoking and pulmonary tuberculosis were still found related to lung cancer and considered as risk factors with OR and its 95% confidence interval 6.996, 3.23-15.14 and 4.82, 1.37-19.97 respectively. But chronic bronchitis failed to relate with lung cancer and was considered as a confounding factor. Of all the female lung cancer cases only 49.1% and 19.3% were smokers and TB patients respectively, hence smoking and TB could be responsible only for a small portion. In cancer cytology, squamous-cell carcinoma appeared to show association with smoking while adenocarcinoma did not. Among female lung cancer cases the proportion of adenocarcinoma exceeded that of squamous-cell carcinoma, and appeared unrelated with smoking. More family members of the lung cancer cases seem to have had malignant histories, suggesting that a hereditary factor of cancer susceptibility might be involved.     

2006-2017年中国女性乳腺癌和生殖系统癌症发病趋势分析

目的 评估2006-2017年不同年龄和地区女性乳腺癌和生殖系统癌症的发病趋势。方法 结合发病率、人口数计算全国分地区、分年龄的女性乳腺癌、外阴癌、阴道癌、宫颈癌、子宫体癌及卵巢癌的发病数及平均诊断年龄。通过世界标准人口进行标化。采用Joinpoint 4.5.0.1软件计算平均年变化百分比（AAPC）。结果 2006-2017年,6种癌症的合计年龄标化发病率（ASIR）从39.48/10万上升至51.11/10万（AAPC=2.24%,95%CI：1.59%~2.89%）。这一上升趋势在农村地区更加显著（AAPC=4.65%,95%CI：3.67%~5.64%）,而城市地区未见明显上升（AAPC=0.15%,95%CI：-0.26%~0.56%）。除子宫体癌外,其他5种癌症发病均呈上升趋势。宫颈癌的ASIR在城市和农村地区上升趋势相近。乳腺癌、阴道癌和外阴癌的ASIR在城市地区无明显上升趋势,而在农村地区明显上升。卵巢癌的ASIR在城市地区呈下降趋势,而在农村地区则呈上升趋势。从发病年龄上看,除子宫体癌外,所有女性癌症平均诊断年龄均呈上升趋势。通过世界标准人口标化后,仅在宫颈癌和阴道癌中观察到标化平均诊断年龄的上升,从49.11岁和55.15岁分别上升至52.13岁和58.81岁。结论 2006-2017年,女性癌症标化发病率总体呈上升趋势,且农村地区上升趋势高于城市地区。同时,农村居民的医疗资源可及性需进一步提升,保证医疗保健服务和早诊早治,从而弥合女性癌症城乡差距。     

Familial clustering of colon,breast, uterine,and ovarian cancers as assessed by family history

The aggregation of colon, endometrial, ovarian, and possibly breast cancers in families has been described as a “cancer family syndrome” (now called Lynch syndrome II). To determine if the familial clustering of these malignancies was more common in women with cancer than without, we analyzed data from the Iowa Women's Health Study (IWHS), a population-based sample of 41,837 women aged 55–69 years. Self-reported information was collected on history of colon, uterine, ovarian, and breast cancers in female first-degree relatives. A family history of cancer of the breast (odds ratio [OR] = 1.4), colon (OR = 1.3), and uterus (OR = 1.3), but not ovary (OR = 1.2), was significantly more common among women with a personal history of any of these four cancers (all P < 0.05); the pattern of the ORs suggested strongly that the clustering tended to be site-specific. Age-adjusted relative risks (RR) of incident colon cancer over 5 years of follow-up (N = 237) were calculated with regard to family history. Colon cancer incidence was increased among women with a family history of breast (RR = l.3), uterine (RR = 1.4), colon (RR = l.5), and ovarian (RR = 1.3) cancers, although none of the risk estimates achieved statistical significance. RR was, however, significantly related to the number of different cancer sites reported among family members (P_trend = 0.008). These data on a representative sample of postmenopausal women suggest that family histories of colon, breast, uterine, and ovarian cancers are associated with an increased risk of cancer at the same site, but provide little support for the hypothesis that Lynch syndrome II is a non-random occurrence. © 1993 Wiley-Liss, Inc.     

Compliance with Papanicolaou smear screening following tubal ligation in women with cervical cancer

To evaluate patient compliance with Papanicolaou (Pap) smear screening after tubal ligation compared with other methods of birth control in patients who develop cervical cancer, a retrospective review of 262 women with cervical cancer diagnosed at age < or = 70 years was undertaken at the Albert Einstein College of Medicine from January 1987 to December 1995. Demographic data, stage of the disease, histologic type, history of smoking, history of sexually transmitted disease (STD), and birth control use were recorded. The Pap screening history was obtained from all the patients. Women who had a bilateral tubal ligation (BTL) were compared with those who did not have this form of birth control. The date and result of their last Pap test prior to their diagnosis of cervical cancer was noted. Two hundred fourteen women with cervical cancer were evaluable. The clinical stage, mean age, history of smoking, and history of STD were similar for both groups. Gravidity among the BTL group was higher than in the non-BTL group (p < 0.01). Forty-eight (22.4%) women had a previous BTL. Twenty-seven of these 48 patients (56.3%) did not have a Pap smear within 3 years prior to the diagnosis of cervical cancer. Of the 166 patients, 61 (36.7%) did not have a Pap test within 3 years (p < 0.05). Fourteen women (29.2%) in the tubal ligation group never returned for a Pap test following the BTL. An average of 6.2+/-5.9 years elapsed since the last Pap test in the BTL group, with 4.0+/-5.1 years in the nontubal ligation group (p < 0.05). There was a correlation between the number of years since BTL (14.2+/-7.7) to the number of years since the last Pap test (6.2+/-5.9) (p < 0.05). Women who have had a BTL should be considered high risk because of poor screening compliance. A Pap test every 3 years is not adequate in this high-risk population group. We advocate improved counseling regarding the importance of continued annual Pap screening for women who are considering tubal ligation.     

近10年子宫切除的原因分析

目的:探讨近10年子宫切除的原因。方法:近10年我院实施子宫切除术妇女2697例,分析手术首要指征和患者年龄。结果:①切除原因为子宫肌瘤62.6%,子宫腺肌病11.0%,子宫脱垂9.5%,恶性肿瘤7.9%,随后是卵巢良性肿瘤、功血、子宫内膜异位症、盆腔炎症、产科因素及CIN。②子宫切除高峰年龄在41~50岁,21~60岁各年龄组子宫肌瘤是首要原因,61~90岁3个年龄组子宫脱垂为首要原因,21~30岁子宫切除前两位原因是子宫肌瘤37.1%(13/35)和宫颈癌31.4%(11/35)。结论:41~50岁是子宫切除的高峰年龄。60岁前、后子宫切除最主要原因分别是子宫肌瘤和子宫脱垂,21~30岁年轻女性宫颈癌是次于子宫肌瘤的子宫切除的重要因素。