CAJ | 학술논문

目的：收集和分析兰陵地区子宫颈癌筛查结果，为子宫颈癌防治提供科学依据。方法以2015年上半年兰陵地区已婚女性入组研究，收集子宫颈脱落细胞标本，采用液基细胞学制片，巴氏染色，在严格诊断质量控制下按子宫颈细胞学Bethesda报告系统的诊断标准进行判读。结果收集标本13832例，标本满意率达99.96%。微生物检出情况：真菌感染99例（0.72%），滴虫感染120例（0.87%），放线菌感染30例（0.22%），细菌性阴道病770例（5.57%），共1019例（7.37%）。子宫颈液基细胞学检测（liquid-based cytology testing，LCT）情况：不能明确意义的不典型鳞状细胞（atypical squamous cells of unknown significance，ASC-US）479例（3.46%），不除外高级别鳞状上皮内病变的不典型鳞状上皮细胞（atypical squamous cells cannot exclude HSIL，ASC-H）25例（0.18%），低级别鳞状上皮内病变（low grade squamous intraepithelial lesions ，LSIL）235例（1.70%），高级别鳞状上皮内病变（high grade squamous intraepithelial lesions ，HSIL）90例（0.65%），鳞状细胞癌（squamous cell carcinomas，SCC）1例（0.01%），不典型腺细胞（atypical glandular cells，AGC）4例（0.03%）。细胞学检查异常共834例，占6.03%。细胞学检查异常人群集中在25~55岁。诊断质量控制结果：不典型鳞状上皮细胞与上皮内病变的比值（ASC/SIL）为1.546；27例HSIL宫颈活检病理结果显示26例为子宫颈上皮内瘤变（ cervical intraepithelial neoplasia，CIN）Ⅱ级、Ⅲ级，符合率为96.3%。结论子宫颈液基细胞学检测能发现子宫颈微生物感染及癌前病变，为子宫颈癌筛查工作提供科学依据。
목적：수집화분석란릉지구자궁경암사사결과，위자궁경암방치제공과학의거。방법이2015년상반년란릉지구이혼녀성입조연구，수집자궁경탈락세포표본，채용액기세포학제편，파씨염색，재엄격진단질량공제하안자궁경세포학Bethesda보고계통적진단표준진행판독。결과수집표본13832례，표본만의솔체99.96%。미생물검출정황：진균감염99례（0.72%），적충감염120례（0.87%），방선균감염30례（0.22%），세균성음도병770례（5.57%），공1019례（7.37%）。자궁경액기세포학검측（liquid-based cytology testing，LCT）정황：불능명학의의적불전형린상세포（atypical squamous cells of unknown significance，ASC-US）479례（3.46%），불제외고급별린상상피내병변적불전형린상상피세포（atypical squamous cells cannot exclude HSIL，ASC-H）25례（0.18%），저급별린상상피내병변（low grade squamous intraepithelial lesions ，LSIL）235례（1.70%），고급별린상상피내병변（high grade squamous intraepithelial lesions ，HSIL）90례（0.65%），린상세포암（squamous cell carcinomas，SCC）1례（0.01%），불전형선세포（atypical glandular cells，AGC）4례（0.03%）。세포학검사이상공834례，점6.03%。세포학검사이상인군집중재25~55세。진단질량공제결과：불전형린상상피세포여상피내병변적비치（ASC/SIL）위1.546；27례HSIL궁경활검병리결과현시26례위자궁경상피내류변（ cervical intraepithelial neoplasia，CIN）Ⅱ급、Ⅲ급，부합솔위96.3%。결론자궁경액기세포학검측능발현자궁경미생물감염급암전병변，위자궁경암사사공작제공과학의거。
Objective To screen married women in Lanling District for cervical cancer using liquid-based cytology testing(LCT). Methods Married women in Lanling district were enrolled into this study in the first half of 2015 based on stratified cluster sampling. Samples were stained by the pap method,analyzed by LCT and diagnosed based on the Tethesda system. Results Screening was completed for 99.96%of the 13,832 samples. Of the 13,832 samples analyzed,90 (0.72%)showed Candida albicans infection;120 (0.87%),vaginal trichomoniasis;30(0.22%),actinomycosis;and 770(5.57%),bacterial vaginosis. A total of 1,019 women(7.37%) showed microbial infections and 834(6.03%)showed cell abnormalities. Women with such abnormalities,most of whom were between 25 and 55 years old,included 479(3.46%)with atypical squamous cells(ASC)of unknown significance(ASC-US),25(0.18%) with atypical squamous cells that might correspond to high-grade squamous intraepithelial lesions(HSIL,ASC-H),235(1.70%)with low-grade squamous intraepithelial lesions(LSIL),90(0.65%)with HSIL,1(0.01%)with squamous cell carcinoma(SCC)and 4 (0.03%)with atypical glandular cells(AGC). The ratio of ASC to squamous intraepithelial lesions was 1.546. Cervical biopsy showed that 26 of the 27 women with HSIL had cervical intraepithelial neoplasia Ⅱ or Ⅲ. The diagnostic coincidence rate was 96.3%. Conclusion Cervical LCT can detect a large number of microbial infections and precancerous lesions,suggesting it is effective for cervical cancer screening of married women.