目的 掌握普查中妇科恶性肿瘤的情况并及时发现问题.方法 采用横断面调查和前瞻性观察相结合的方法对上海地区2000至2009年普查发现的455例宫颈癌、子宫内膜癌和卵巢癌病例和生存情况进行分析.结果 上海市经过普查检出宫颈癌发病率呈逐年上升趋势,并已接近上海市疾控中心报告的全市发病率水平.普查前有高危因素的占40.0%;普查前有相关症状的占5.7%;普查时被查出阳性体征的占47.3%.子宫内膜癌患者的体征阳性率显著低于其他两癌(χ2=37.1033,P=0.000),卵巢癌的症状阳性率显著低于其他两癌(χ2=15.3416,P=0.000).与国内其他研究比较,普查检出宫颈癌的临床分期早.经普查检出的宫颈癌、子宫内膜癌和卵巢癌5年生存率分别为96.9%、96.2%、75.3%.结论 上海市宫颈癌发病率通年上升,子宫内膜癌和卵巢癌的筛查方法有待提高.建议加强健康教育和对妇科癌症高危妇女的健康管理.%Objective To master the status of gynecologic malignant tumors through mass screening and explore the problems. Methods Cross-sectional investigation and prospective observation were used to analyze the 455 cases of cervical cancer, endometrial cancer or ovarian cancer detected through mass screening in Shanghai from 2000 to 2009 and their survival status. Results The incidence rate of cervical cancer detected through mass screening was rising year by year, and it was near to that of the whole city reported by Shanghai CDC. There were 40% of cases having risk factors before mass screening, 5. 7% having related symptoms before mass screening and 47. 3% being found with positive signs in mass screening. The positive sign rate of cases of endometrial cancer was significantly lower than that of cases of other two cancers (χ2 =37. 1033 ,P =0. 000 ), and the symptom positive rate of ovarian cancer was lower than that of other two cancers (χ2 = 15. 3416 ,P = 0.000 ). The cervical cancer cases detected through mass screening had earlier clinic stage than the cases in other studies. The 5 year survival rate of cervical cancer, endometrial cancer and ovarian cancer cases detected through mass screening was 96. 9% , 96. 2% and 75. 3% respectively. Conclusion The mass screening has benefit to the early diagnosis of gynecologic tumors and their prognosis. The screening method to detect endometrial cancer and ovarian cancer needs to be improved. It is suggested to strengthen health education and the health management on high-risk women.
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