CAJ | 학술논문

目的探讨官颈癌及癌前病变筛查的可行性.方法行程控超薄细胞检测系统(TCT)检查5545例,对其中307例阳性和219例阴性但临床可疑宫颈病变共计526例进一步行阴道镜及镜下取活检病理检查,以病理组织学为金标准,对结果进行分析.结果单因素Logistic回归分析与宫颈上皮内瘤变(CIN)相关的危险因素为宫颈HPV感染、性活动开始年龄、性伴数、性生活防护、STD病史、年龄及流产次数(P<0.05).TCT和阴道镜与病理诊断的符合率分别为49.4%和83.8%;TCT对低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)及鳞癌(CC)的漏诊率分别为63.63%、74.44%、100%,阴道镜对LSIL、HSIL.及CC的漏诊率分别为33.37%、12.22%、0.TCT、阴道镜、TCT联合阴道镜诊断GIN以上的灵敏度分别为61.2%、84.6%、94.5%,特异性分别为85.4%、88.2%、90.8%.结论 (1)女性CIN和宫颈癌的发生与宫颈人乳头腺病毒(HPV)感染、性行为以及各种下生殖道感染等因素相关.(2)液基细胞学可用于宫颈病变的初筛,TCT检查联合阴道镜下活组织检查,可提高宫颈病变的检出率及准确率,两者联合能满足早期子宫颈癌及癌前病变筛查的需要.
목적 탐토관경암급암전병변사사적가행성.방법 행정공초박세포검측계통(TCT)검사5545례,대기중307례양성화219례음성단림상가의궁경병변공계526례진일보행음도경급경하취활검병리검사,이병리조직학위금표준,대결과진행분석.결과 단인소Logistic회귀분석여궁경상피내류변(CIN)상관적위험인소위궁경HPV감염、성활동개시년령、성반수、성생활방호、STD병사、년령급유산차수(P<0.05).TCT화음도경여병리진단적부합솔분별위49.4%화83.8%;TCT대저도린상상피내병변(LSIL)、고도린상상피내병변(HSIL)급린암(CC)적루진솔분별위63.63%、74.44%、100%,음도경대LSIL、HSIL.급CC적루진솔분별위33.37%、12.22%、0.TCT、음도경、TCT연합음도경진단GIN이상적령민도분별위61.2%、84.6%、94.5%,특이성분별위85.4%、88.2%、90.8%.결론 (1)녀성CIN화궁경암적발생여궁경인유두선병독(HPV)감염、성행위이급각충하생식도감염등인소상관.(2)액기세포학가용우궁경병변적초사,TCT검사연합음도경하활조직검사,가제고궁경병변적검출솔급준학솔,량자연합능만족조기자궁경암급암전병변사사적수요.
Objective To discuss the correlation between cervical intraepithelial neoplasia(CIN) and uterine cervix cancer and the combination of TCT and colposcope for the investigation of cervical lesion.Methods 5545 patients were preliminarily screened by cervical fluid basement cell folium smear,in which 307 patients are masculine and 219 are negative,the 526 patients are suspected cervical lesions in clinical symptoms and they further underwent colposcopy and biopsy,the results were analyzed by pathohistology which is golden standard.Results CIN coherent dangerous factors analyzed by single factor Logistic regression analysis are:cervical HPV pollution,age of sexual activity,sexual partners numbers,protection of sexual life, STD history,age and frequency of miscarriage ( P < 0.05 ).The coincidence between TCT,colposeopy and pathologic diagnosis are 49.4%, 83.8% ;the omission diagnostic rate of LSIL,HSIL and CC from TCT are 63.63% ,74.44% ,100% ;the omission diagnostic rate of LSIL,HSIL and CC from colposcopy are 33.37%, 12.22% ,0;the sensitivity of TCT,colposcopy and TCT combine colposcopy for CIN are 61.2% ,84.6% ,94.5% and specificity are 85.4% ,88.2.% ,90.8%.Conclusions (1)The generation of CIN and cervical cancer are correlated with cervical HPV pollution,sexual behavior and various kinds of lower genital tract infection.(2) Fluid basement cell folium smear can promote the property of diagnosis,meet the demands of early stage uterus neck cancer and precancer lesion investigation,are suitable to be routine cheek methods in primary hospital.