摘要
目的 统计分析2020-2022 连续三年女性健康查体人群宫颈细胞学（TCT）和人乳头瘤病毒（HPV）的流行分布，为更有效的制定监测宫颈癌防治策略提供依据。方法 采集天津市三甲医院的女性体检患者的宫颈分泌物，分别进行液基薄层细胞学（TCT）检查和人乳头瘤病毒（HPV）分子检测，并对结果进行分析。结果 三年总计纳入18,585例女性体检者，其中17,473例进行细胞学（TCT）检查，包括 2020年3,854例，2021年7,402例，2022年6,217例；其余1,112例进行人乳头瘤病毒（HPV）分子检测，包括2021年619例，2022年493例。TCT检查结果显示，三年平均阳性率为2.507%，2021年阳性率最高为2.905%；三年间阳性率有显著差异（*P＜0.05)，其中2020年与2021年阳性率差异最明显（**P＜0.005）。HPV检测平均阳性率为10.522%，各年份间没有显著性差异（P＞0.05），其中，2021年阳性率较高, 为11.309%。此外，TCT和HPV阳性检出结果均呈现年龄升高的趋势。结论 贯彻并加强女性定期规范的宫颈癌普查，是有效预防、及时诊疗甚至消灭宫颈癌的必备环节。我们应该提高具有性生活期女性，尤其是宫颈癌高发年龄段女性的宫颈癌筛查意识。
关键词： 液基薄层细胞学检查；人乳头瘤病毒；宫颈病变；宫颈癌；流行率
Abstract
Objective To analyze the prevalence and distribution of cervical cytology (TCT) and human papillomavirus (HPV) in women's health checkup population for three consecutive years from 2020 to 2022, so as to provide a basis for more effective monitoring of cervical cancer prevention and treatment strategies. Methods Cervical secretions from female physical examination patients in Tianjin Grade A Hospital were collected and analyzed by liquid base thin layer cytology (TCT) and human papillomavirus (HPV) molecular detection respectively. Results A total of 18,585 female physical examination subjects were included in the three-year study, of which 17,473 underwent TCT examination, including 3,854 in 2020, 7,402 in 2021, and 6,217 in 2022. The remaining 1,112 were tested for human papillomavirus (HPV) molecules, including 619 in 2021 and 493 in 2022. TCT examination results showed that the three-year average positive rate was 2.507%, and the highest positive rate was 2.905% in 2021. There was a significant difference in the positive rate in three years (*P < 0.05), and the difference between 2020 and 2021 was the most significant (**P < 0.005). The average positive rate of HPV detection was 10.522%, with no significant difference among different years (P > 0.05), and the positive rate in 2021 was 11.309%. In addition, both TCT and HPV-positive detection results showed an increasing trend of age. Conclusion To carry out and strengthen regular and standardized cervical cancer screening is an essential link for effective prevention, timely diagnosis and treatment and even elimination of cervical cancer. We should improve the awareness of cervical cancer screening for women with sexual life, especially women in the age group with high incidence of cervical cancer.
Key words： liquid-base thin-layer cytology; Human papillomavirus; Cervical lesions; Cervical cancer; Prevalence rate
参考文献 References
[1] SUNG H, FERLAY J, SIEGEL R L, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries [J]. CA Cancer J Clin, 2021, 71(3): 209-49.
[2] Global Cancer Observatorv. https://gco.iarc.fr/.[EB/OL].
[3] BOSCH F X, LORINCZ A, MUñOZ N, et al. The causal relation between human papillomavirus and cervical cancer [J]. Journal of clinical pathology, 2002, 55(4): 244-65.
[4] 白小龙, 李恂, 潘秀丹, 等. 2010-2014年沈阳市宫颈癌发病与死亡分析[J]. 现代预防医学, 2017, 44(02): 243-246+249.
[5] 朱晓华, 张晓兰, 卢锦,等. 高危型人乳头状瘤病毒配合液基薄层细胞学检查在宫颈癌早期癌前病变筛查中的应用价值分析[J]. 中国卫生检验杂志,2019, 29(12): 1502-5.
[6] CANFELL K, KIM J J, BRISSON M, et al. Mortality impact of achieving WHO cervical cancer elimination targets: a comparative modelling analysis in 78 low-income and lower-middle-income countries [J]. Lancet (London, England), 2020, 395(10224): 591-603.
[7] 刘思乐, 赵方建, 陈键. 人乳头瘤病毒分型及液基薄层细胞检测在宫颈病变筛查中的价值分析 [J]. 中国社区医师,2022, 38(36): 86-8.
[8] MARCUS J Z, CASON P, DOWNS L S, JR., et al. The ASCCP Cervical Cancer Screening Task Force Endorsement and Opinion on the American Cancer Society Updated Cervical Cancer Screening Guidelines [J]. Journal of lower genital tract disease, 2021, 25(3): 187-91.
[9] 何婵婵,曾典,张玥,等.全球各国宫颈癌筛查年龄范围的分析与讨论[J].现代预防医学,2024,51(04):630-639.
[10] 蔡会龙, 原伟光, 孙惠昕. 全球及我国宫颈癌流行现状及防治策略 [J]. 临床肿瘤学杂志,2023, 28(01): 90-3.
[11] WANG R, GUO XL, WISMAN GB , et al. Nationwide prevalence of human papillomavirus infection and viral genotype distributionin 37 cities in China [J]. BMC InfectDis, 2015,15:257
[12] 范剑武,冯周楠,毕忠晖. 临海市女性HPV感染情况分析 [J]. 健康教育与健康促进, 2024,19(02): 195-197.
[13] 林堃,黄洁香,洪奇阳, 等. 福建省莆田市115455例女性HPV感染及宫颈病变流行病学分析 [J].福建医科大学学报 , 2024, 58(02): 135-142.
[14] 师艺,董潇阳,买为丽旦·衣明江, 等. 乌鲁木齐市11654例女性HPV分型及定量检测结果分析[J]. 检验医学与临床, 2024,21(12):1697-1703.
[15] 张增霞,李义文,王云.潍坊地区18237例女性人乳头瘤病毒感染情况及不同年龄感染者病毒基因型分布特点 [J]. 山东医药, 2024,64(16):29-32+37.