CAJ | 학술논문

目的探讨宫颈癌机会性筛查用于宫颈癌早期诊断、早期治疗的意义。方法对2011年8月～2012年8月在我院妇科门诊就诊行宫颈癌机会性筛查5698例患者进行回顾性总结分析。2011年8月～2012年8月在我院妇科门诊就诊5698例患者进行宫颈癌机会性筛查，为A组，对接受筛查的患者行以宫颈细胞学检查或细胞学方法和高危型HPV- DNA检查联合使用作为初步筛查，对结果可疑或阳性的患者进行阴道镜检查，进行阴道镜检查时，对有可疑的病变图像在阴道镜下取宫颈活组织检查，假如在阴道镜下见宫颈无明显癌变可疑区时，可在转化区3、6、9、12点4处取材做病理检查，所取组织应包括间质及邻近正常组织，对于宫颈光滑或宫颈活组织检查阴性，应用小刮匙搔刮宫颈管，刮出物送病理检查，组织病理学诊断最终判断宫颈病变性质。结果5312例患者愿意接受筛查，顺应性为93.2%；液基细胞学阳性检出率为11.35%；阴道镜检查感染率为32.61%；病理活检阳性率为20.72%。将此次数据与2009～2010年我院对社区进行组织性筛查共5262例患者的数据进行比较，为B组，顺应性和液基细胞学阳性检出率存在明显差异（P＜0.05），阴道镜检查感染率和病理活检阳性率无明显差异。结论通过对妇科门诊患者进行宫颈癌机会性筛查，可以更好地提高防治效果及广大妇女对宫颈癌的认知度，对宫颈癌的早期诊断与早期治疗有着非常重要的意义。
목적탐토궁경암궤회성사사용우궁경암조기진단、조기치료적의의。방법대2011년8월～2012년8월재아원부과문진취진행궁경암궤회성사사5698례환자진행회고성총결분석。2011년8월～2012년8월재아원부과문진취진5698례환자진행궁경암궤회성사사，위A조，대접수사사적환자행이궁경세포학검사혹세포학방법화고위형HPV- DNA검사연합사용작위초보사사，대결과가의혹양성적환자진행음도경검사，진행음도경검사시，대유가의적병변도상재음도경하취궁경활조직검사，가여재음도경하견궁경무명현암변가의구시，가재전화구3、6、9、12점4처취재주병리검사，소취조직응포괄간질급린근정상조직，대우궁경광활혹궁경활조직검사음성，응용소괄시소괄궁경관，괄출물송병리검사，조직병이학진단최종판단궁경병변성질。결과5312례환자원의접수사사，순응성위93.2%；액기세포학양성검출솔위11.35%；음도경검사감염솔위32.61%；병리활검양성솔위20.72%。장차차수거여2009～2010년아원대사구진행조직성사사공5262례환자적수거진행비교，위B조，순응성화액기세포학양성검출솔존재명현차이（P＜0.05），음도경검사감염솔화병리활검양성솔무명현차이。결론통과대부과문진환자진행궁경암궤회성사사，가이경호지제고방치효과급엄대부녀대궁경암적인지도，대궁경암적조기진단여조기치료유착비상중요적의의。
Objective To investigate the significance of cervical cancer opportunistic screening for the early diagnosis and early treatment. Methods The cervical cancer opportunistic screening data of 5698 patients treated in the outpatient department of our hospital from August 2011 to August 2012 were analyzed retrospectively.5698 patients treated in the outpatient department of our hospital from August 2011 to August 2012 were given cervical cancer opportunistic screening,which was group A.These patients received the cervical cytological examination or the combined cytological method and high-risk HPV-DNA examination as the primary screening.The patients with suspicious or positive results were given the colposcopical examination.During the colposcopical examination,for patients with suspicious lesion images,the cervical biopsy was conducted under colposcopy.If no obvious suspicious canceration area was observed under cloposcopy, the tissues of point 3,6,9 and 12 in the transformation zone could be used for pathological examination. The selected tissues should include mesenchyma and adjacent normal tissues. For the patients with smooth cervix or negative cervical biopsy results,the cervical canal should be scratched using a small curet. Then the scatched tissue was sent for pathological examination. The histopathological disgnosis judged the quality of cervical lesions eventually. Results 5312 patients were willing to accept the screening,with the compliance of 93.2%;The positive detection rate of liquid based cytology was 11.35%;The infection rate of colposcopy was 32.61%;The positive rate of pathological biopsy was 20.72%.The data were compared to those of the 5262 patients who received community screening organized by our hospital from 2009 to 2010,which was group B.The two groups were significantly different in the compliance and positive detection rate of liquid based cytology (P<0.05),but were not significantly different in the infection rate of colposcopy and positive rate of pathological biopsy. Conclusion The implementation of cervical cancer opportunistic screening among gynecological outpatients can better improve the prevention and control effects and the women's awareness of cervical cancer,which is of very important significance to the early diagnosis and early treatment of cervical cancer.