山西省襄垣县采用careHPV检测技术进行宫颈癌初筛的效果分析

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[目的]评价care HPV检测技术在农村宫颈癌筛查中的应用情况。[方法]对山西襄垣县2270名35~64岁妇女采用care HPV检测技术进行宫颈癌初筛,初筛阳性者接受液基细胞学分流,分流阳性者召回阴道镜检查及活检,以病理结果为金标准。[结果]参加筛查的妇女平均年龄45.7±6.8岁,care HPV阳性率为12.9%(292/2270),阴道镜转诊率为4.8%(109/2270),CIN1、CIN2+检出率分别为1.4%(31/2270)和1.7%(38/2270)。在既往筛查史上,参加过筛查的妇女CIN2+的检出率要低于从未参加过筛查的妇女(χ2=4.50,P=0.042)。[结论 ]care HPV检测技术初筛细胞学分流的筛查策略有助于在降低阴道镜转诊率的同时,提高宫颈病变的检出率,扩大筛查覆盖面。该策略适用于资源相对贫乏的农村地区。 [Objective] To evaluate the application of care HPV detection in rural cervical cancer screening. [Methods] 2270 women aged 35-64 years in Xiangyuan County of Shanxi Province were enrolled in this study. Cervical cancer was screened by care HPV test. Patients with positive primary screening underwent liquid-based cytological shunt and positive shunt were recalled by colposcopy and biopsy. The pathological results were gold standard. [Results] The average age of women participating in the screening was 45.7 ± 6.8 years, the positive rate of care HPV was 12.9% (292/2270), the colposcopy referral rate was 4.8% (109/2270), the detection rates of CIN1 and CIN2 + were 1.4% (31/2270) and 1.7% (38/2270). In previous screening history, the screening rate of CIN2 + in women who participated in screening was lower than those who had never participated in screening (χ2 = 4.50, P = 0.042). [Conclusion] The screening strategy of care HPV detection technology for primary screening of cytological diversion helps to improve the detection rate of cervical lesions and extend the screening coverage while reducing the colposcopy referral rate. This strategy is applicable to rural areas where resources are relatively scarce.
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