2015―2017年河北省农村妇女宫颈病变筛查项目数据分析

李娜; 郑振茹; 张献波; 钱立杰; 李进华

doi:10.16462/j.cnki.zhjbkz.2021.10.016

2015―2017年河北省农村妇女宫颈病变筛查项目数据分析

doi: 10.16462/j.cnki.zhjbkz.2021.10.016

1.
050051 石家庄，河北省人民医院肿瘤内科
2.
050031 石家庄，河北省妇幼保健中心

详细信息

通讯作者:
李娜，E-mail: ln81420@126.com

中图分类号: R181.1;R711.74
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- 被引次数: 0
出版历程
- 收稿日期: 2021-02-02
- 修回日期: 2021-05-03
- 网络出版日期: 2021-11-17
- 刊出日期: 2021-10-10

Analysis of cervical lesion screening of rural women in Hebei Province from 2015 to 2017

1.
Department of Oncology, Hebei Province People's Hospital, Shijiazhuang, Hebei 050051, China
2.
Hebei Women and Children's Health Center, Shijiazhuang, Hebei 050031, China

More Information

Corresponding author: LI Na, E-mail: ln81420@126.com

摘要

摘要: 目的分析2015―2017年河北省农村妇女宫颈病变筛查项目的数据，评价项目开展实施情况。方法对2015―2017年河北省12个地区下属县、区及1个直管县共66个县、区35~64岁已婚农村妇女进行妇科检查及宫颈病变筛查，细胞学检查阳性者行阴道镜检查，阴道镜检查结果怀疑宫颈病变的多点组织活检行病理学检查。收集各监测点上报数据，应用SPSS 22.0软件进行统计学分析。结果 2015―2017年河北省运用贝塞斯达系统(the Bethesda system, TBS)分类的描述性报告的比例分别为95.26%、95.23%和96.66%。阴道镜异常检出率从2015年的19.62%(2 040例)下降到2017年的17.45%(1 968例)(χ² =16.84, P＜0.001)，组织病理学异常检出率由2015年的26.87%(588例)上升至2017年的38.41%(822例)(χ² =65.56, P＜0.001)。宫颈癌前病变检出率由2015年的75.27/10万逐年提高到2017年105.91/10万(χ² =23.86, P＜0.001)。宫颈浸润癌检出率由2015年的17.28/10万上升至2017年的21.07/10万(χ² =2.77, P=0.251)，早期诊断率由2015年84.94%逐年增至2017年的86.80%(χ² =0.57, P=0.751)。结论河北省宫颈癌筛查项目达到一定的筛查目的及效果，尤其是癌前病变筛查方面，但是在阴道镜和组织病理学检查方面仍需优化，技术有待提高。
- 农村妇女 /
- 宫颈病变 /
- 筛查 /
- 河北省
Abstract: Objective To analyze the data of rural women's cervical disease screening project in Hebei Province from 2015-2017, and to evaluate the implementation condition of the project. Methods Gynecological examination and cervical cytology examination were conducted on married women aged 35-64 years in rural regions of 66 prefectures/counties during 2015-2017. Colposcopy was performed among the examinees with abnormal cervical cytology and multiple biopsy was subsequently carried out among the examinees with suspicious cervical lesions. We collected the data onto each monitoring point. SPSS 22.0 system software has used for statistical analysis. Results From 2015 to 2017, the proportion of descriptive reports using the Bethesda system (TBS) classification in Hebei Province was 95.26%, 95.23% and 96.66%, respectively. The abnormal detection rate of colposcopy discreased from 19.62% (n=2 040) in 2015 to 17.45% (n=1 968) in 2017 (χ² =16.84, P < 0.001). The abnormality rate of histopathology increased from 26.87% (n=588) in 2015 to 38.41% (n=822) in 2017 (χ² =65.56, P < 0.001). The detection rate of cervical precancerous lesions increased from 75.27/100 000 in 2015 to 105.91/100 000 in 2017(χ² =23.86, P < 0.001). The detection rate of cervical invasive cancer increased from 17.28/100 000 in 2015 to 21.07/100 000 in 2017 (χ² =2.77, P=0.251). The early diagnosis rate increased from 84.94% in 2015 to 86.80% in 2017(χ² =0.57, P=0.751). Conclusions The cervical cancer screening project of Hebei Province has achieved certain screening effect, especially in the screening of precancerous lesions. However, the quality of colposcope and histopathology need to be optimized.
- Rural women /
- Cervical lesion /
- Screening /
- Hebei Province

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表 1 2015―2017河北省农村妇女宫颈癌初筛方法筛查结果

Table 1. Screening results of primary cervical cancer screening methods for rural women in Hebei Province from 2015-2017

方法	2015年(n=358 723)			2016年(n=367 114)			2017年(n=370 129)
方法	初筛人数(例)	阳性人数(例)	阳性率(%)	初筛人数(例)	阳性人数(例)	阳性率(%)	初筛人数(例)	阳性人数(例)	阳性率(%)
宫颈细胞学检查	356 994	10 031	2.81	366 232	8 372	2.29	367 096	10 979	3.00
巴氏涂片检查	15 287	114	0.75	16 640	151	0.91	9 340	11	0.12
TCT	341 707	9 917	2.90	349 592	8 221	2.35	357 756	10 968	3.07
VIA/VILI	1 468	46	3.13	377	71	18.83	359	50	13.93

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表 2 2015―2017年河北省初步筛查、阴道镜及组织病理学阳性结果情况

Table 2. Positive results of preliminary screening, colposcopy and histopathology in Hebei Province from 2015 to 2017

年份	初筛		阴道镜			病理活检
年份	阳性例数(例)	阳性率(%)	检查人数(例)	异常人数(例)	异常率(%)	异常人数(例)	异常率(%)
2015	10 077	2.81	10 398	2 040	19.62	588	26.87
2016	8 443	2.30	8 717	1 536	17.62	640	38.55
2017	11 029	2.98	11 276	1 968	17.45	822	38.41

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表 3 2015―2017年河北省农村妇女子宫颈癌前病变、宫颈癌检出和早期诊断情况

Table 3. Comparison of detection rate and early diagnosis rate of cervial precancerous lesions and cercival cancer among rural women in Hebei Province from 2015 to 2017

分类	2015年(n=358 723)		2016年(n=367 114)		2017年(n=370 129)		χ²值	P值
分类	检出例数(例)	检出率(/10⁵)	检出例数(例)	检出率(/10⁵)	检出例数(例)	检出率(/10⁵)	χ²值	P值
宫颈浸润癌及癌前病变	332	89.76	348	94.79	470	126.98	26.02	＜0.001
宫颈癌前病变	270	75.27	289	78.72	392	105.91	23.86	＜0.001
宫颈浸润癌	62	17.28	59	16.07	78	21.07	2.77	0.251
早期诊断(%)	282	84.94	300	86.20	408	86.80	0.57	0.751

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表 4 2015―2017年河北省农村妇女不同程度宫颈病变检出情况

Table 4. Detection of cervical lesions of different degrees in rural women in Hebei Province from 2015 to 2017

分类	2015年(n=358 723)		2016年(n=367 114)		2017年(n=370 129)		χ²值	P值
分类	检出例数(例)	检出率(/10⁵)	检出例数(例)	检出率(/10⁵)	检出例数(例)	检出率(/10⁵)	χ²值	P值
低级别病变	253	70.53	283	77.09	352	95.10	14.65	0.001
高级别病变	255	71.09	286	77.91	381	102.94	24.53	＜0.001
原位腺癌	15	4.18	9	2.45	11	2.97	1.79	0.409
微小浸润癌	12	3.35	11	3.00	16	4.32	0.98	0.613
浸润癌	50	13.94	48	13.08	62	16.75	1.87	0.393

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