南京市65613例体检妇女宫颈癌筛查的的结果分析.docVIP

南京市65613例体检妇女宫颈癌筛查的的结果分析 　　[摘要] 目的 探讨宫颈液基薄层细胞学检测（thinprep cytology test， TCT）技术在体检妇女宫颈癌筛查中的作用。 方法 选取2011年1月～2013年6月期间来我院妇保科体检并进行TCT宫颈细胞学检查的65 613例女性患者，对其中细胞学阳性的患者进行阴道镜检查及宫颈活体组织检查，并以组织病理学结果为最终诊断依据。对这类人群的检查结果做一回顾性研究分析。细胞学诊断标准按照TBS（2001）分类，组织学诊断标准根据WHO2014分类，分别将TCT 诊断≥ASCUS 为阳性，宫颈活检病理诊断≥CINI 为阳性。 结果 65 613例TCT细胞学检查中，合格样本61 550例。发现阳性病例（ASC-US及以上）3577例，其中1052例在本院进行了阴道镜检查及活检。TCT诊断的敏感度和特异度分别为79.29%和30.27%。各年龄段的CIN病例分布中51～60岁组的CIN比例高于其他年龄组，且差异有统计学意义（P0.05）。 结论 TCT是目前较为有效的宫颈癌筛查手段，建议30～60岁妇女每年用该检测技术进行一次宫颈癌的细胞学筛查。 　　[关键词] 宫颈液基细胞学检查；组织病理学；宫颈癌筛查；体检 　　[中图分类号] R737.33 [文献标识码] B [文章编号] 1673-9701（2014）33-0072-03 　　[Abstract] Objective To investigate the value of Thinprep Cytology Test（TCT） medical examination women of cervical cancer screening examination. Methods A total of 65613 women who came to our hospital to take physical examination from January 2011 to June 2013 were selected and screened for cervical cancer with TCT. Colposcopy and cervical biopsy were conducted for patients with positive cytology. And we identify the histopathological results as the final diagnosis. Results Among the 3577 women of 65613 cases， 1052 women took the colposcopy and biopsy. Cytology results on the distribution of the histopathological results constitute the ratio was statistically significant （P0.05）. Diagnostic sensitivity and specificity of TCT were 79.29% and 30.27% respectively .The CIN ratio of 51 to 60 year old group was lower than other age groups， the difference was statistically significant （P0.05）. Conclusion TCT is a more effective means of cervical cancer screening. We suggest that women aged 30 to 60 should do the test of cervical cytology once a year. 　　[Key words] Cervical thinprep cytology test； Histopathology； Cervical cancer screening； Physical examination 　　宫颈癌是严重威胁妇女健康的第2位恶性肿瘤，中国癌症预防与控制规划纲要（2004～2010）将其列为8种癌症防治重点之一[1]。目前宫颈癌发病率逐年升高，且有年轻化趋势，其与HPV感染、生产次数多及人工流产次数多等多种因素有关[2]。预防宫颈癌可以通过早期筛查和早期干预来实现[3]。薄层液基细胞学检测技术具有简便易行、无创伤、经济有效并且可以多次重复等优点，是目前应用最为广泛的宫颈癌筛查技术。近两年全国各地都在广泛进行两癌筛查的