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目的了解不同农村地区宫颈病变及宫颈癌的发生情况。方法 2014年1月至8月在山西省古交市(县级市)、北京市密云县和河北省曲周县,根据国家宫颈癌检查项目的人群年龄要求在35~64岁,具有当地户口的农村妇女,共收集7 138例;其中古交市2 444例,密云县2 350例,曲周县2 344例。经研究对象知情同意后进行宫颈细胞学检查,对细胞学结果为ASCUS及以上的病例进行阴道镜检查。所有细胞学及组织病理学检测均委托第3方检验公司,并由医院专业医生对其进行质控。结果在7 138例检查人群中,检出细胞学在不典型增生(ASCUS)及以上的病例共计247例,检出率为3.5%;其中ASCUS119例、不典型鳞状上皮细胞(ASCH)19例、低度病变(LSIL)73例、高度病变(HSIL)34例、非典型腺上皮细胞(AGC)2例,检出率分别为1.7%、0.3%、1.0%、0.5%和0.03%。不同项目县细胞学异常的检出率不同,古交市细胞学异常的比例(5.3%)高于其他两县(2.4%和2.6%),差异有统计学意义(χ2=36.984,P=0.000)。古交市患者的宫颈上皮内瘤变(CIN)Ⅱ及以上病变的检出率最高为1.35%,高于其他两县(0.30%和0.47%),差异有统计学意义(χ2=23.725,P=0.000)。结论不同地区宫颈病变和宫颈癌的检出率有所不同;通过良好的质量控制能够提高细胞学异常及宫颈癌前病变的检出率。
Objective To understand the occurrence of cervical lesions and cervical cancer in different rural areas. Methods From January to August 2014, Gujiao City (county-level city) in Shanxi Province, Miyun County in Beijing and Quzhou County in Hebei Province were aged 35-64 years old according to the age group of the national cervical cancer screening program. Local age groups Of rural women, a total of 7,138 cases were collected, of which 2 444 cases were in Gujiao City, 2 350 cases in Miyun County and 2 344 cases in Quzhou County. Cervical cytology was performed after informed consent of the subjects and colposcopy was performed on ASCUS and above cytology results. All cytology and histopathology tests were commissioned by a third-party testing firm and quality-controlled by a hospital physician. Results A total of 247 cases were found in 7 138 cases of ASCUS. The detection rate was 3.5%. Among them, ASCUS was found in 119 cases and atypical squamous cell (ASCH) in 19 cases , 73 cases of low grade lesion (LSIL), 34 cases of high grade lesion (HSIL) and 2 cases of atypical glandular epithelial cells (AGC). The detection rates were 1.7%, 0.3%, 1.0%, 0.5% and 0.03% respectively. The detection rates of cytological abnormalities in different counties were different, the cytology abnormalities in Gujiao City were higher than those in the other two counties (2.4% vs 2.6%) (χ2 = 36.984, P = 0.000 ). In Gujiao City, the highest detection rate of cervical intraepithelial neoplasia (CIN) Ⅱ and above lesions was 1.35%, which was higher than that of other two counties (0.30% and 0.47%) (χ2 = 23.725, P = 0.000). Conclusions The detection rate of cervical lesions and cervical cancer in different areas is different. Good quality control can improve the detection rate of cytological abnormalities and cervical precancerous lesions.