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论著:10349例已婚妇女妇科普查结果分析
Analysis of the Results of the Gynecological General Survey on 10 349 Women
陈红梅
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作者单位:复旦大学附属妇产科医院体检中心
中文关键字:妇科普查;宫颈上皮内瘤变;宫颈癌;人乳头状瘤病毒;TCT细胞学检查;阴道镜
英文关键字:Gynecological general survey;Cervical intraepithelial neoplasia;Cervical carcinoma;Human papillomavirus;Thinprep cytologic test;Colposcopy
中文摘要:目的:了解中国妇女妇科健康状况,探索科学的妇科普查方法。方法:回顾分析2009年11月—2010年10月在复旦大学附属妇产科医院体检中心进行妇科普查的10349例已婚妇女的常规体格检查、盆腔B超检查、白带常规检查、宫颈细胞学检查(包括巴氏涂片法或新柏氏TCT法)等资料。部分妇女进行高危型人乳头状瘤病毒(HR-HPV)检测,HR-HPV阳性或TCT异常者进行阴道镜病理组织学检查。结果:10 349例体检妇女中发现慢性宫颈炎2 100例,患病率为21.8%;子宫肌瘤1 371例,患病率为14.2%;乳腺病878例,患病率为8.5%;阴道炎420例,患病率为4.1%。在296例HR-HPV阳性或TCT异常者中发现宫颈上皮内瘤变56例,早期宫颈浸润癌4例。TCT异常组的宫颈上皮内瘤变发生率显著高于HR-HPV阳性组的上皮内瘤变发生率。结论:妇科普查能及时发现妇科常见病,TCT和HR-HPV联合检查有助于宫颈上皮内瘤变的早期诊断。
英文摘要:Objective: To investigate the health state of the Chinese women by gynecological general survey and to explore the scientific method of gynecological examination. Methods: We collected 10349 Chinese women who did gynecological examination in the Obstetrics and Gynecology Hospital of Fudan University from November 2009 to October 2010.The examination included physical examination, pelvic B-sonography, leucorrhea conventional check, cervical cytology (Pap smear or Thinprep cytologic test). High-risk human papillomavirus (HR-HPV) was tested in part of the women. Women with HPV-positive or aberrant TCT were volunteered to be selected to do colposcopy and histopathological examination. Results: In all 10349 women, there were 2100 cases with chronic cervicitis (incidence: 21.8%), 1371 cases with myoma of uterus (incidence:10.2%), 878 cases with mastosis (incidence:8.5%) and 420 cases with vaginitis (incidence:4.1%). In 296 women with positive HPV or aberrant TCT results, we found 56 cases had cervical intraepithelial neoplasia (CIN) and 4 cases had early invasive cervical carcinoma. The incidence of CIN in populations with aberrant TCT results was much higher than that in the populations with HPV positive. Conclusions: Gynecological general survey can timely detect gynecological diseases. The combined test of TCT and PHV contribute to the early diagnosis of CIN.
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