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目的分析2014年抚宁县农村妇女宫颈癌癌前病变(CIN)的筛查数据,为早期防治宫颈癌提供科学依据。方法对抚宁县农村妇女(35~64岁)分别进行液基薄层细胞学(TCT)检测3 000例为TCT组,进行人乳头瘤病毒(HPV)16/18型检测3 000例为HPV组,TCT联合HPV 16/18型检测3 000例为TCT联合HPV组,3组阳性者均经阴道镜取活体组织检查(活检),以组织学为金标准,比较3组阳性检出率与组织学诊断的符合率。结果 TCT与HPV单项检出率分别为26.30%和32.40%,而两者联合检出率为46.20%,与病理诊断符合率分别为82.76%、91.15%、96.75%,符合率组间差异有统计学意义(χ~2=10.699,P<0.05);CIN和宫颈癌患者与正常者阴道分泌物白细胞数量及酸碱度比较,差异有统计学意义(t=2.832、2.347;2.211、1.794,均P<0.05)。结论 TCT和HPV联合检测可提高CIN检出率,两者互补,降低单一检查造成的假阴性率,从而更有利于体检时早期发现CIN,积极治疗并防止恶变。CIN是一个缓慢的过程,尤其在35~50岁之间的女性应该增加对其检查的次数,以做到早发现、早治疗,同时应该注意个人卫生,以减少CIN患病率,提高农村妇女生活质量,提高家庭生活幸福指数。
Objective To analyze the screening data of cervical precancerous lesions (CIN) in rural women in Funing County in 2014, and provide a scientific basis for the prevention and treatment of cervical cancer in the early stage. Methods A total of 3 000 cases of TCT were detected in rural women (35-64 years old) in Funing County as TCT group, and HPV type 16/18 was detected in 3 000 cases as HPV group , TCT combined with HPV16 / 18 type detection of 3 000 cases of TCT combined with HPV group, 3 were positive by colposcopic biopsy (biopsy) to histology as the gold standard, the positive rate of the three groups compared with the organization The diagnosis of the coincidence rate. Results The single detection rates of TCT and HPV were 26.30% and 32.40% respectively, but the combined detection rate was 46.20%. The coincidence rates with pathological diagnosis were 82.76%, 91.15% and 96.75% respectively. The coincidence rates were statistically significant (Χ ~ 2 = 10.699, P <0.05). There were significant differences in the number of white blood cells and the pH value of vaginal secretions between CIN and cervical cancer patients (t = 2.832,2.347,2.211,1.794, P < 0.05). Conclusion Combined detection of TCT and HPV can increase the detection rate of CIN, complementing each other and reducing the false negative rate caused by a single examination, which is more conducive to the early detection of CIN during physical examination and active treatment and prevent malignant transformation. CIN is a slow process, especially for women between the ages of 35 and 50 years. The number of examinations should be increased so that early detection and early treatment can be carried out. At the same time, attention should be paid to personal hygiene so as to reduce the prevalence of CIN and increase the risk of rural women Quality of life, improve the happiness of family life index.