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目的:通过对基层医院实施宫颈癌筛查的质量控制结果进行分析,进而不断优化农村地区女性宫颈癌筛查的流程,提高基层医院病理科医生对于宫颈癌诊断的准确性。方法:2013~2015年选取浙江省台州市具有农村户籍的女性38294例、38108例及37365例为研究对象,从2014年起加强质量控制,对相关的宫颈癌筛查病理质量控制结果进行分析。结果:2013~2015年农村女性的液基薄层细胞检测阳性发现率分别为2.19%、2.01%、2.30%。对2013~2015年农村女性的液基薄层细胞检测阳性的患者,进行阴道镜检查并取宫颈组织进行病理学活检,宫颈病理学组织检查阳性发现率分别为20.90%、24.68%、24.93%;液基薄层细胞检查阴性的患者进行复核,符合率分别为96.58%、98.21%、99.25%,液基薄层细胞检查阳性的患者进行复核,符合率分别为80.25%、86.76%、92.45%;宫颈组织切片阳性的患者进行复核,符合率分别为77.78%、86.36%、96.15%,宫颈组织切片阴性的患者进行复核,符合率分别为91.18%、94.87%、97.01%。结论:通过不断加强农村女性宫颈癌筛查病理的质量控制,农村女性宫颈癌检出率明显提高,假阳性及假阴性逐年下降。
OBJECTIVE: To analyze the quality control results of cervical cancer screening in primary hospitals and further optimize the screening procedure of cervical cancer in women in rural areas so as to improve the accuracy of diagnosis of cervical cancer by pathologists in primary hospitals. Methods: From 2013 to 2015, 38294 women, 38108 women and 37365 women with rural domicile in Taizhou, Zhejiang Province were selected as research objects. Since 2014, quality control has been strengthened and the results of pathological quality control of cervical cancer screening have been analyzed. Results: The positive detection rates of liquid-based thin-layer cells in rural women from 2013 to 2015 were 2.19%, 2.01% and 2.30%, respectively. The positive rate of cervical biopsy and cervical pathology was 20.90%, 24.68% and 24.93% respectively for colposcopy examination and cervical smear positive cell examination in rural women from 2013 to 2015. The patients who were negative for liquid - based thin - layer cytology were reviewed. The coincidence rates were 96.58%, 98.21% and 99.25% respectively. The coincidence rates were 80.25%, 86.76% and 92.45% respectively. Cervical section positive patients were reviewed, the coincidence rates were 77.78%, 86.36%, 96.15%, respectively. The coincidence rates were 91.18%, 94.87% and 97.01% respectively. Conclusion: By continuously improving the quality control of cervical cancer screening in rural women, the detection rate of cervical cancer in rural women was significantly increased, while the false positives and false negatives decreased year by year.