论文部分内容阅读
[目的]分析重庆市宫颈癌机会性筛查的基本现状,探索适合重庆市宫颈癌机会性筛查方法。[方法]收集分析2009年重庆市8家医院机会性筛查资料,筛查方法包括液基细胞学、巴氏涂片、HPVDNA检测,以及专家推荐的三种筛查方案,Ⅰ方案:HPV检测和液基细胞学组合;Ⅱ方案:传统巴氏涂片和HPV检测;Ⅲ方案:仅用肉眼观察(醋酸或碘染色法,VIA/VILI)。病理确诊宫颈病变及宫颈癌,并对受检妇女进行流行病学调查。[结果]筛查过程中医生实际使用液基细胞学2390例(64.26%),Ⅲ方案2300例(61.84%),巴氏涂片194例(5.22%),Ⅰ方案103例(2.77%),Ⅱ方案52例(1.40%),HPVDNA检测17例(0.46%),最普遍采用的方法是液基细胞学、肉眼观察。检出CIN217例,检出率为9.68%;宫颈癌22例,检出率为0.98%。对受检妇女进行流行病学调查显示,愿意选择液基细胞学所占比例(69.69%)最高,其次分别为阴道镜(47.26%)、VIA/VILI(40.04%)、巴氏涂片(4.35%),所占比例最低为HPVDNA(3.54%),而经济欠发达、文化程度低、年长者、家人未患有肿瘤者更愿意选择传统筛查方法。[结论]不管是筛查过程中医生实际使用,还是受检妇女的选择,均是以细胞学为重庆市宫颈癌的主要检测手段,液基细胞学正逐步被广泛使用;而肉眼观察仍为重庆市经济欠发达地区宫颈癌筛查的另一主要检测手段。
[Objective] To analyze the basic situation of opportunistic screening of cervical cancer in Chongqing and explore the suitable screening method for cervical cancer in Chongqing. [Methods] The data of opportunistic screening in 8 hospitals in Chongqing in 2009 were collected and analyzed. The screening methods included liquid-based cytology, Pap smear, HPVDNA test and three screening programs recommended by experts. Ⅰ Plan: HPV test And liquid-based cytology; Ⅱ program: the traditional Pap smear and HPV testing; Ⅲ program: only with the naked eye (acetic acid or iodine staining, VIA / VILI). Pathological diagnosis of cervical lesions and cervical cancer, and the subjects of the epidemiological survey. [Results] 2390 cases (64.26%) of liquid-based cytology, 2300 cases (61.84%) of Ⅲ plan, 194 cases (5.22%) of Pap smear, 103 cases (2.77% Fifty-two cases (1.40%) were diagnosed by Ⅱ protocol and 17 cases (0.46%) by HPVDNA test. The most common method was liquid-based cytology. Detected CIN217 cases, the detection rate was 9.68%; 22 cases of cervical cancer, the detection rate was 0.98%. Epidemiological survey of women tested showed that the proportion of liquid-based cytology (69.69%) was the highest, followed by colposcopy (47.26%), VIA / VILI (40.04%), Pap smear %), The lowest proportion of HPVDNA (3.54%), while the economy is less developed, with a low level of education, elderly, family members without cancer are more willing to choose the traditional screening methods. [Conclusion] Whether it is the practical use of the doctor in the screening process or the choice of the women under test, cytology is the main detection method of cervical cancer in Chongqing. Liquid-based cytology is gradually being widely used; however, the naked eye observation is still Chongqing City, underdeveloped areas of cervical cancer screening another major means of detection.