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目的探讨山东省东营地区农村中老年妇女宫颈癌发病特点和防治对策。方法对东营地区2010-03-01-2013-10-31已婚或有性生活史的农村35~60岁18 365名妇女进行宫颈病变筛查资料分析,检查项目包括妇科检查、彩色超声、阴道及宫颈分泌物涂片显微镜检查和宫颈脱落细胞液基薄层细胞学(thinprep cytologic test,TCT)检测,对检查可疑或异常者,再进行阴道镜和宫颈组织病理学检查。结果查及各种妇科疾病占26.11%(4 796/18 365),其中生殖道炎症占16.23%(2 980/18 365),宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)占3.79%(697/18 365),宫颈癌占0.15%(28/18 365)。各级CIN和浸润癌发病中位数年龄均位于41~50岁年龄组,浸润癌检出率在35~40和41~50岁组,与51~60岁组差异无统计学意义(P>0.05),具有显著的年轻化趋势。CINⅠ中位数年龄为42.5岁,CINⅡ为45.5岁,CINⅢ为48.5岁,宫颈浸润癌为49.5岁。结论东营地区CIN和宫颈癌检出率较高。应该加大免费筛查力度,有针对性地对不同年龄段开展宫颈癌检查,提高CIN和宫颈癌诊断的效率,并对筛查出的宫颈癌和CIN积极治疗随访,有效阻断宫颈癌的发生。
Objective To investigate the incidence and prevention and treatment of cervical cancer in rural middle-aged and elderly women in Dongying, Shandong Province. Methods A total of 18 365 women 35 to 60 years of age in rural areas of Married or with sex history from March to March 2010 were enrolled in the cervical lesions screening test. The items included gynecological examination, color ultrasound, vagina And cervical secretions smear microscopy and cervical exfoliative cytology-based thin-layer cytology test (TCT), to check for suspicious or abnormal, colposcopy and cervical histopathological examination. The results of gynecological diseases accounted for 26.11% (4 796/18 365), of which genital tract inflammation accounted for 16.23% (2 980/18 365), cervical intraepithelial neoplasia (CIN) accounted for 3.79% ( 697/18 365), cervical cancer 0.15% (28/18 365). The median age of CIN and invasive carcinoma at all levels were in the age group of 41-50 years. The detection rate of invasive carcinoma in 35-40 and 41-50 years old group was not significantly different from that of 51-60 years old group (P> 0.05), with a significant trend of younger age. The median age of CIN I was 42.5 years, CIN II 45.5 years, CIN III 48.5 years, and invasive cervical cancer 49.5 years. Conclusion Dongying CIN and cervical cancer detection rate higher. Should increase the intensity of free screening, targeted at different ages to carry out cervical cancer examination, improve the diagnostic efficiency of CIN and cervical cancer, and screening of cervical cancer and CIN positive treatment follow-up, effectively blocking cervical cancer occur.