HPV检测技术初筛巴氏涂片分流应用于农村女性宫颈癌筛查效果

发布时间：2018-03-30 18:00

本文选题：宫颈肿瘤　切入点：多相筛查　出处：《中华疾病控制杂志》2017年05期

【摘要】：目的分析人乳头瘤病毒(human papillomavirus,HPV)检测技术初筛巴氏涂片分流应用于农村女性宫颈癌筛查中的效果。方法 2015年对35~64岁农村女性使用HPV检测进行宫颈癌初筛,阳性者采用巴氏涂片法分流,巴氏涂片结果为不明确意义的非典型鳞状细胞(atypical squamous cells of undetermined signification,ASCUS)及以上病变的女性转用阴道镜检查。所有阴道镜下检查异常或不满意处均取活检或宫颈管搔刮术(endocervical canal curettage,ECC),病理结果为中度子宫颈上皮内瘤变(cervical intraepithelial neoplasia grade 2,CIN2)及以上者转诊进行手术治疗。结果 HPV初筛、巴氏涂片分流策略HPV筛查阳性率为10.65%。CIN2及以上者共150人,全部进行阴道镜检查,实际阴道镜转诊率为3.55%,阴道镜顺应性为100%。经病理诊断,本次筛查分别发现轻度子宫颈上皮内瘤变(cervical intraepithelial neoplasia grade 1,CIN1)、CIN2及以上、重度子宫颈上皮内瘤变(cervical intraepithelial neoplasia grade 3,CIN3)及以上分别为16例(0.38%)、29例(0.69%)、15例(0.36%),未发现宫颈癌病例。结论 HPV初筛、巴氏涂片分流策略能够降低阴道镜转诊率,宫颈疾病检出率较高,可以在有条件的农村地区使用。但宫颈癌前病变及宫颈癌的检出率较HPV初筛不分流低,需要进一步加强对基层细胞学医生技术水平的规范化培训。
[Abstract]:Objective to analyze the effect of screening pasteurized smear shunt with human papillomavirus (HPV) technique in screening cervical cancer in rural women. Methods in 2015, 35 ~ 64 years old rural women were screened by HPV. The positive patients were shunt by pasteurized smear. Atypical squamous cells of undetermined significance of atypical squamous cells of undetermined verification ASCUSS) and above were switched to colposcopy. Biopsy or cervical canal scratching of endocervical canal were performed in all cases of abnormal or unsatisfactory findings under colposcopy. The pathological results were moderate cervical intraepithelial neoplasia (intraepithelial neoplasia grade 2CIN2) and above. Results HPV was first screened. The positive rate of HPV screening for pasteurized smear shunt strategy was 150 people with 10.65%.CIN2 and above. All of them underwent colposcopy examination. The actual colposcopy referral rate was 3.55 and the colposcopy compliance was 100. In this screening, cervical intraepithelial neoplasia grade 1 was found to be cervical intraepithelial neoplasia and CIN2 +, and severe cervical intraepithelial neoplasia grade 3CIN3 was found in 16 patients with cervical intraepithelial neoplasia and above, respectively. 29 cases of cervical intraepithelial neoplasia and above were 0.38 and 0.69%, 15 cases were 0.366.Conclusion No cases of cervical cancer were found. The pasteurized smear shunt strategy can reduce the rate of colposcopy referral, the detection rate of cervical diseases is higher and can be used in conditional rural areas, but the detection rate of precancerous lesions and cervical cancer is lower than that of HPV screening. Need to further strengthen the basic level of cytology doctors technical level standardized training.
【作者单位】：河南省新密市妇幼保健院保健科;上海市计划生育科学研究所生殖流行病与社会医学研究室;四川省肿瘤医院·研究所癌症防治中心办公室;北京协和医学院/中国医学科学院肿瘤医院流行病学研究室;
【基金】：重大公共卫生专项(2100409)
【分类号】：R737.33

【相似文献】