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目的探讨农村维吾尔族妇女宫颈癌的筛查方法,以提高宫颈癌早诊早治率,降低死亡率。方法于2013年5-11月在新疆和田墨玉县进行宫颈筛查研究,对年龄21~60岁的已婚妇女6 000例进行care HPV(德国QIANEN公司)及国产液基细胞学检查(泰普生物科学有限公司)的检测,将care HPV阳性或TCT≥ASC-US的女性再次召回行阴道镜检查及宫颈活检。结果 (1)病理结果中慢性宫颈炎442例,CINⅠ47例,CINⅡ48例,CINⅢ53例,宫颈癌11例(包括9例宫颈鳞癌及2例宫颈腺癌),病理结果中有1例宫颈结核。宫颈上皮内瘤变Ⅰ~Ⅲ级148例,检出率为2.47%,宫颈癌11例,检出率为0.18%。(2)用care HPV法检测出的HPV阳性人数为505例,HPV感染率为8.42%,TCT结果中阳性人数271例,HPV感染率为4.52%;在148例宫颈癌前病变中HPV感染率为97.30%,在宫颈癌病例中HPV感染率为100%。(3)年龄>45岁妇女HPV感染率高于≤45岁者(χ2=15.835,P<0.001);<30岁者CIN2+宫颈病变发生率较低,>30岁者宫颈病变发生率较高,差异具有统计学意义(χ2=5.534,P=0.019)。(4)女性的早诊率为98.21%(110/112),早治率为75.0%(84/112)。结论 care HPV和国产液基细胞学检查可以用于宫颈癌的筛查,筛查年龄应该从30岁开始,>45岁的妇女加强HPV检测,应该加强新疆农村地区宫颈癌的宣传工作。
Objective To investigate the screening methods of cervical cancer in rural Uygur women to improve the early diagnosis and treatment of cervical cancer and reduce the mortality rate. Methods Cervical screening was performed in Moyu County, Hotan, Xinjiang from May to November in 2013. 6 000 married women aged 21 to 60 years were enrolled in the study of HPV (QIANEN Co., Germany) and domestic liquid-based cytology Cape Bioscience Co., Ltd.) test, the women with HPV-positive or TCT-ASC-US were again referred for colposcopy and cervical biopsy. Results (1) The pathological findings of 442 cases of chronic cervicitis, CIN Ⅰ in 47 cases, CIN Ⅱ in 48 cases, CIN Ⅲ in 53 cases, 11 cases of cervical cancer (including 9 cases of cervical squamous cell carcinoma and 2 cases of cervical adenocarcinoma), pathological findings in 1 case of cervical tuberculosis. Cervical intraepithelial neoplasia grade Ⅰ ~ Ⅲ 148 cases, the detection rate was 2.47%, 11 cases of cervical cancer, the detection rate was 0.18%. (2) The number of HPV positive cases detected by care HPV method was 505, the infection rate of HPV was 8.42%, the number of positive cases in TCT was 271 cases, and the HPV infection rate was 4.52%. In 148 cervical precancerous lesions, the HPV infection rate 97.30%, HPV infection in cervical cancer cases was 100%. (3) The HPV infection rate of women aged> 45 years old was higher than those of ≤45 years (χ2 = 15.835, P <0.001). The incidence of CIN2 + cervical lesions was lower in patients <30 years old, The difference was statistically significant (χ2 = 5.534, P = 0.019). (4) The rate of early diagnosis was 98.21% (110/112) in women and 75.0% (84/112) in early pregnancy. CONCLUSION: The combination of care HPV and homemade liquid-based cytology can be used to screen cervical cancer. Screening age should be from 30 years old. Women over 45 years old should strengthen HPV testing and cervical cancer promotion should be strengthened in rural areas of Xinjiang.