宫颈癌筛查8463例结果分析

目的探讨宫颈癌筛查中不同检查方法的临床应用价值。方法 按照宫颈癌"三阶梯"筛查方案,对2007年1月至2010年12月在暨南大学附属第一医院接受宫颈癌筛查的8463例女性个体的筛查结果进行统计学分析(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,征得受试对象本人的知情同意,并与之签署临床研究知情同意书)。结果 8463例受试者的宫颈细胞学结果≥未明确诊断意义的不典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASCUS)检出率为3.06%(259/8463),≥高级别宫颈鳞状上皮内瘤变(high-grade intraepithelial lesion,HSIL)检出率为0.67%(57/8463)。1380例接受人乳头状瘤病毒(human papilloma virus,HPV)检测受试者的人乳头状瘤病毒感染率为32.17%(444/1380),其中高危型人乳头状瘤病毒(high-risk humanpapilloma virus,HR-HPV)感染率为27.32%(377/1380),低危型人乳头状瘤病毒(low-risk humanpapilloma virus,LR-HPV)为4.86%(67/1380);HPV-16,-58,-52,-53和-33型等5种最常见的高危型人乳头状瘤病毒感染率分别为33.16%(125/377),21.22%(80/377),20.16%(76/377),10.61%(40/377)和9.55%(36/377)。760例接受阴道镜检查的受试者中,阴道镜检查异常检出率为42.50%(323/760)。371例接受组织病理学检查者,结果正常为10.24%(38/371);慢性宫颈炎及鳞状上皮化生为34.77%(129/371);宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅰ为21.02%(78/371),CINⅡ为13.48%(50/371),CINⅢ为14.82%(55/371),宫颈癌为5.66%(21/371)。其中宫颈癌及癌前病变检出率为44.20%(164/371)。其中,高度上皮瘤变(≥CINⅡ)检出率为31.54%(117/371)。结论 按照"三阶梯"方案进行宫颈癌筛查,应制定个体化筛查方案。

Analysis on the Results of 8463 Cases in Cervical Cancer Screening

Objective To evaluate the clinical application of different approaches in cervical cancer screening.Methods From January 2007 to December 2010,a total of 8463 women who received cervical the cancer screening at First Affiliated Hospital of Jinan University according to three-step technique were recruited into this study.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the First Affiliated Hospital of Jinan University.Informed consent was obtained from all partic...