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目的探讨宫颈细胞学(包括巴式涂片及超柏氏薄层液基细胞学)及阴道镜检查筛查内蒙古镶黄旗地区妇女宫颈病变的现状及临床意义。方法2004年7月至2009年1月对内蒙古镶黄旗地区的642例28～67岁有性生活妇女进行宫颈病变筛查,其中557例妇女行传统宫颈巴式涂片法,85例妇女行宫颈超柏氏薄层液基细胞学,并对宫颈细胞学异常者(≥ASCUS)行阴道镜检查及活检。结果642例妇女中宫颈细胞学阳性(≥ASCUS)者34例,占5.3%(34/642),其中ASCUS者22例,占64.7%(22/34);低度鳞状上皮内病变(LSIL)者6例,占17.6%(6/34);高度鳞状上皮内病变(HSIL)者6例,占17.6%(6/34),其中有1例肯定为宫颈癌。宫颈细胞学阴性608例,占94.7%(608/642)。宫颈细胞学阳性34例人群中,行阴道镜活检病理检查者有25例,其中慢性宫颈炎13例(52.0%);CIN1为5例(20.0%);CIN2为4例(16.0%);CIN3为1例(4.0%);浸润癌为2例(8.0%)。结论应重视并及时进行经济不发达地区妇女人群宫颈病变的早期筛查,传统宫颈巴式涂片法及阴道镜活检及病理学检查为可行的筛查方法,有条件者可进行宫颈薄层液基细胞学结合阴道镜活检及病理学检查,对提高早期宫颈癌筛查的准确性效果明显。对内蒙古等西部地区,应在完善技术力量支持、筛查质量控制、建立筛查后的转诊制度及治疗的绿色通道等方面,以降低宫颈癌的发病率。
Objective To investigate the status and clinical significance of cervical cytology (including Pap smear and Paecillus serosa) and colposcopy screening of cervical lesions in women in Xianghuangqi, Inner Mongolia. Methods From July 2004 to January 2009, 642 women with sexual life from 28 to 67 years old in the Xianghuangqi area of Inner Mongolia were screened for cervical lesions. Among them, 557 women underwent traditional cervical smears and 85 women underwent cervix Pao Bo thin layer liquid-based cytology, and cervical cytology abnormalities (≥ ASCUS) colposcopy and biopsy. Results Among 642 women, 34 were positive for cervical cytology (≥ASCUS), accounting for 5.3% (34/642), of which 22 were ASCUS (64.7%, 22/34). Low grade squamous intraepithelial lesion ) Were found in 6 cases (17.6%, 6/34). Six cases were highly squamous intraepithelial lesion (HSIL), accounting for 17.6% (6/34), of which 1 was confirmed as cervical cancer. Cervical cytology negative 608 cases, accounting for 94.7% (608/642). Cervical cytology was positive in 34 cases of patients, colposcopy biopsy pathology were 25 cases, of which 13 cases of chronic cervicitis (52.0%); CIN1 in 5 cases (20.0%); CIN2 in 4 cases (16.0%); CIN3 1 case (4.0%); 2 cases of invasive carcinoma (8.0%). Conclusion Early screening of cervical lesions in women population in economically underdeveloped areas should be paid attention to and the screening method of cervical smears and colposcopy biopsy and pathological examination should be used as feasible screening methods. Cervical laminar fluid Basal cells combined with colposcopy biopsy and pathological examination, to improve the accuracy of early cervical cancer screening effect is obvious. For Inner Mongolia and other western regions, we should improve the technical support, screening quality control, establishment of a screening referral system and treatment of the green channel, in order to reduce the incidence of cervical cancer.