文章摘要
安徽省73239例宫颈液基细胞学的Bethesda系统报告结果分析
Analysis of report results of Bethesda systemin 73 239 casesof cervical liquid based cytology in Anhui province
投稿时间：2016-11-08  
DOI：10.3969/j.issn.1000-0399.2017.04.031
中文关键词: 宫颈癌  筛查  宫颈液基细胞学
英文关键词: Cervical cancer  Screening  Cervical liquid based cytology
基金项目:
作者单位E-mail
许雪 230088 安徽合肥 金域医学检验所有限公司病理科  
葛霞 230088 安徽合肥 金域医学检验所有限公司病理科 gexiabbmc@sohu.com 
袁金萍 230088 安徽合肥 金域医学检验所有限公司病理科  
刘泊江 230088 安徽合肥 金域医学检验所有限公司病理科  
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中文摘要:
      目的 分析宫颈液基细胞学的Bethesda系统（TBS）报告结果，评估安徽省妇女宫颈病变发病的年龄分布特点及地区特点，通过计算液基细胞学高级别病变的阳性预测值，评估其在宫颈癌筛查中的作用，为安徽省的宫颈癌筛查提供数据参考。方法 2015年1月至2015年12月对合肥金域医学检验所有限公司病理科检测的73 239例宫颈液基细胞学TBS报告结果进行数据分析，以及分析宫颈液基细胞学筛查高级别及以上病变对应组织学诊断的符合率。采用χ2检验，计算阳性率及宫颈病变的年龄发病率、地区发病率差异。计算高级别病变的阳性预测值。结果 73 239例标本中筛查出7 102例宫颈癌及癌前病变（阳性率9.70%）；各年龄组宫颈病变检出率：≤20岁9.72%，20岁<年龄≤30岁8.21%，30<年龄≤40岁9.41%，40<年龄≤50岁10.65%，50岁<年龄<60岁10.17%，≥60岁9.53%（65岁以上10.2%）；高级别及以上病变检出率：≤20岁0.22%，20岁<年龄≤30岁0.80%，30<年龄≤40岁1.51%，40<年龄≤50岁2.13%，50岁<年龄<60岁2.30%，≥60岁2.58%（65岁以上2.94%），高级别病变的检出率随着年龄的增加而逐渐增加。皖南地区阳性率为9.9%，皖北为9.5%，差异有统计学意义（P<0.05）。其中安庆、蚌埠、池州地区的高级别及以上病变检出率分别为2.26%，2.26%，2.15%，高于其他地区。288例高级别及以上病变中有组织学活检/锥切报告结果，234例为高级别及以上病变（阳性预测值为81.25%），癌或疑癌19例病例中18例为高级别及以上病变（阳性预测值为94.74%）。结论 宫颈细胞学可作为宫颈癌筛查的手段，建议安徽省宫颈癌筛查可以从30岁开始，重点在40岁及以上年龄段，40岁以下可以适当延长筛查间隔；终止年龄应放宽至65岁以上；同时应加大对皖南山区及偏远地区的宫颈癌筛查力度。
英文摘要:
      Objective To study the age distribution of the population at high risk of cervical cancer and regional differences in Anhui province via calculating the positive predictive value of liquid based cytology test in cervical cancer screening, and to evaluate its role in the diagnosis of cervical cancer, so as to provide data reference for cervical cancer screening in Anhui province.Methods Based on the data analysis of the results according to the TBS report of 73 239 cases of cervical liquid based cytology,the coincidence rate of HSILwas analysed,and the above pathological changes of cervical fluid based cytology screening were compared.Chi-square test was used to determine the difference between the level of disease in different age, different areas of incidenceand their correlation was analysed. The morbidity differences were compared and the cytological and histologicalcoincidence was analysed.Results The positive rate of the sample was 9.70%.Age-specific prevalence of cervical lesions:≤20 year age groupwas 9.72%, 21 to 30 age groupwas 8.21%, 31 to 40 age group was 9.41%, 41 to 50 age group was 10.65%, 51 to 60 age group was 10.17%,≥60 age group was 9.53%(≥65 age group was10.2%).The detection rate of high-grade lesions increased with age.Area-specific prevalence of cervical lesions:the southern of Anhui province was 9.9%, the northern of Anhui province was 9.5%,and the difference of this was statistically significant.The detection rate of HSIL and above lesions in Anqing, Bengbu and Chizhou areas was 2.26%, 2.26% and 2.15%,respectively, which was significantly higher than that in other regions.Conclusion Cervical liquid based cytology can be used as a screening tool for cervical cancer.The improved cervical cancer screening starting age should be above 30 years old and terminating age above 65 years old.Efforts should be strengthened in cervical cancer screening in southern mountains of Anhui Province.
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