液基细胞学用于外来工妇女宫颈癌前病变筛查的临床意义

摘要

目的:探讨液基细胞学检查用于外来工妇女宫颈癌前病变筛查中的诊断价值及宫颈癌筛查现状.方法:应用液基细胞学(TCT)对到我院门诊就诊的外来工妇女(外来组)2 500名和进行常规宫颈癌前病变筛查的常住妇女1 600名(本地组)进行对比,并对其中细胞学筛查异常者进行阴道镜及镜下宫颈活检病理检查.结果:外来工妇女中,检测前有阴道排液或性生活出血等症状者878例,占35.12%,本地组有症状者87例,占5.43%.外来组共检测出细胞阳性368例,占14.72%,本地组异常例数为110例,占6.87%,两组比较,差异有统计学意义(P<0.05).对细胞学检查异常者进行阴道镜及镜下宫颈活检病理检查,其中CINⅠ级以上360例,符合率达75.3%.结论:门诊就诊的外来妇女与本地妇女相比较,宫颈癌前病变发病率较高,有症状者来院就诊比率明显升高,外来组妇女对宫颈癌前病变筛查认识普及率低下,因此常规对外来工就诊妇女进行液基细胞学检查,并结合阴道镜宫颈活检,是筛查和诊断宫颈癌前病变的可靠手段.%Objective: To discuss the diagnostic value of screening tests for precancerous lesions of the uterine cervix by means of liquid based cytology in female migrant workers and to survey the status of screening tests for precancerous lesions of the uterine cervix. Methods: 2 500 female migrant workers who went to our hospital for treatment in the method of liquid based cytology (TCT) compared with 1 600 towns women who went to our hospital for routine examination in screening tests for precancerous lesions of the uterine cervix, then examined the women whose index were abnormal by means of colposcopy and cervical biopsy. Results: 878 female migrant workers had the symptoms of draining the liquid from vagina before examination and bleeding during intercourse, accounting for 35.12％; and 87 towns women had the symptoms, accounting for 5.43％. There were 368 cases in female migrant workers whose index were positive, accounting for 14.72％; and 110 cases in towns women whose index were abnormal, accounting for 6.87％. The differences between the two groups had statistical significance (P＜0.05). there were 360 cases whose index were higher than CIN Ⅰ after examined the wonen whose index were abnormal by the means of colposcopy and cervical biopsy, the concordance rate was 75.3％. Conclusion: The incidence of precancerous lesions of the uterine cervix in migrant group is higher than that in native group, and the rate of seeing doctor timely increased significantly, a small proportion of female migrant workers realize the importance of screening tests for precancerous lesions of the uterine cervix. So it is a reliable method for screening and diagnosing in precancerous lesions of the uterine cervix in the means of liquid based cytology combined with colposcopy and cervical biopsy.