摘 要 目的：比較用宮頸刮板和用宮頸刷采集樣品篩查宮頸癌的效果。方法：將2012年采用宮頸木制刮板采集宮頸脫落細(xì)胞的39 886例篩查婦女作為A組，將2013年采用宮頸刷采集宮頸脫落細(xì)胞的35 663例婦女作為B組。比較巴氏涂片異常檢出率，對(duì)巴氏Ⅱb及以上患者進(jìn)行陰道鏡和病理學(xué)檢查，比較兩組宮頸癌前病變及宮頸癌的檢出率。結(jié)果：B組巴氏異常的檢出率為0.95%（338/35 663），明顯高于A組的0.80%（319/39 886），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；B組的巴氏Ⅱb及以上檢出率為0.53%（190/35 663）也明顯高于A組的0.34%（135/39 886），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；對(duì)于巴氏Ⅱb及以上的患者進(jìn)行陰道鏡和病理檢查，A組檢查的符合率為77.7%（108/135），B組檢查的符合率94.7%（180/190），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。B組宮頸癌前病變LSIL和HSIL的檢出率為0.22%和0.19%，均明顯高于A組的0.08%和0.13%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；B組宮頸低級(jí)別病變的占比（39.80%）高于A組（22.22%）差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：在宮頸癌篩查中使用宮頸刷采集宮頸脫落細(xì)胞篩查效果優(yōu)于宮頸刮板。
　　關(guān)鍵詞 宮頸癌；篩查；宮頸刷；宮頸刮板；宮頸脫落細(xì)胞
　　中圖分類號(hào)：R737.33 文獻(xiàn)標(biāo)志碼：A 文章編號(hào)：1006-1533（2018）04-0059-04
　　Comparative analysis of the effects of cervical scraper and cervical brush in screening for cervical cancer
　　CHEN Xiuhua， ZHANG Min， YANG Qing， CHEN Wei
　�。∕aternal and Child Health Care Center of Songjiang District， Shanghai 201620， China）
　　ABSTRACT Objective： To compare the effects of cervical scraper and cervical brush to collect samples for screening cervical cancer. Methods： The Pap smear examination was performed to the collected female cervical exfoliative cells to compare the detection of cervical lesions and the early diagnosis. In 2012， 39 886 cases of cervical exfoliative cells collected by cervical wood scraper were screened as group A， and in 2013 35 663 women who used cervical brush to collect cervical exfoliative cells were treated as group B. With Pap smear abnormal detection rate， the patients with pasteurized II B and above were examined with the colposcopy and pathological examination. The detection rates of the two groups of cervical precancerous lesions and cervical cancer were compared. Results： The detection rate of pasteurized abnormality in group B was 0.95%（338/35 663）， which was significantly higher than that in group A 0.80%（319/39 886）， and the difference was statistically significant（P<0.05）. The detection rate of Pasteur II B and above in group B was 0.53% （190/35 663）， which was significantly higher than that in group A 0.34%（135/39 886）， and the difference was statistically significant（P<0.05）. Colposcopy and pathological examination were performed for patients with Pasteur II B or above. The coincidence rate of group A was 77.7%（108/135）， that of group B was 94.7%（180/190）， and the difference was statistically significant（P<0.05）. The detection rates of LSIL and HSIL for cervical precancerous lesions in group B were 0.22% and 0.19%， which were significantly higher than those in group A 0.08% and 0.13%， and the difference was statistically significant（P<0.05）. The proportion of low grade cervical lesions in group B accounted for 39.80%， which was higher than that in group A 22.22%， and the difference was statistically significant（P<0.05）. Conclusion： The effect of collecting cervical exfoliative cells by cervical brush in screening cervical cancer is better than that by cervical wood scraper.

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