宫颈疾病筛查项目在妇科专项体检中的应用状况

 目的 调查宫颈疾病筛查项目在常规体检中的应用状况。方法 回顾分析2010年1月1日至2011年12月31日复旦大学附属妇产科医院体检中心所有参加体检的24 135例次资料,调查其宫颈疾病筛查项目状况,包括巴氏涂片检查(Papanicolaou smear,Pap)、液基细胞学检测(thinprep cytology test,TCT)、人乳头瘤病毒(human papillomavirus,HPV)检测及联合检测(HPV+Pap或HPV+TCT)的应用情况,同时计算HPV检测人群中病毒负荷量的分布情况。结果 行Pap检查者12 967例次(53.7%),TCT检测者9 516例次(39.4%),HPV检测者5 517例次(22.9%),联合检测共计5 461例次(22.7%)。宫颈异常阳性检出率TCT高于Pap (χ2=3.866,P=0.049)。分层分析表明,HPV+Pap或HPV+TCT的联合检测法均显著优于单纯Pap或TCT检测(χ2=419.954, P=0.000;χ2=588.001,P=0.000),提示HPV检测的重要性。结论 妇科专项体检中宫颈疾病筛查方法传统,HPV检测和联合检测应用率偏低,应引起重视。同时,对于HPV负荷量≤100 RLU/CO的高危人群宜跟踪随访,以早期发现病变、降低宫颈癌发病风险。

Cervical screening procedures in physical examination for females

Objective To investigate cervical screening procedures in routine physical examinations.Methods We investigated the applications of screening methods including the Papanicolaou smear (Pap),thinprep cytology test (TCT),the human papillomavirus (HPV) test and co testing (HPV+Pap,or HPV+ TCT).Meanwhile,we calculated the distribution of viral load among those received HPV test.Results Among the 24 135 women,53.7% received Pap test,39.4% received TCT,22.9 received HPV,and 22.7% received co testing.On confirming abnormal cervical problems,the positive rate of TCT was higher than Pap (χ2=3.866,P=0.049).Meanwhile,stratified analysis confirmed that the positive rate of either HPV+Pap or HPV+TCT was higher than Pap or TCT test (χ2=419.954,P=0.000;χ2=588.001,P=0.000),which hinted the importance of HPV test.Conclusions The cervical screening procedures is still traditional,and the use ratio of HPV test or co testing is very low,which should be paid more attention.Meanwhile,for those high risk women with≤100 RLU/CO viral load of HPV,follow ups should be made in order to find diseases earlier and decrease the risk of cervical cancer.