关键词: 妇科普查, 宫颈癌, HPV, TCT, 阴道镜

Abstract: Objective To investigate the health state of the cervical of women in Hunan by gynecological general survey and to explore the best method of gynecological examination． Method：We analysed the result of 24817 Chinese women from Hunan Province who underwent gynecological examination in the examnation center of the third affliated Xiangya Hospital from July 2012 to July 2013．The examination included physical examination，cervical cytology(Thinprep cytologic test or Pap smear) and high-risk human papmomavirus(HR—HPV)．Women with HPVpositive or aberrant TCT were advised to do colposcopy and histopathological examination． Results In all 24817 subjects，there were 14779 cases having chronic cervicitis (incidence：59.6％)。The sensitivity of TCT for screening cervical precancerous lesion or early cervical cancer is 92.56％,and ．specificity is 80.05％ , and thepositive rate was 2.95%，and the false-negative rate was 0.18％.And that of Pap smear was 57.35％，97.33％，1.65％，1.45%，respectively. There were significant difference between the two groups(P<0.05)。the rate of HR—HPV infection was 17.67％.Totally 709 biopsy specimens were obtained，46 of 709 patients were diagnosed CINI，36 were diagnosed CIN II，48 were diagnosed CINⅢ，10 patients were diagnosed early cervical cancer and 1 was diagnosed invasive cervical cancer。Using pathologic histology result as a gold standard, the incidence of CIN（31.4％）in populations with aberrant TCT results was higher than that in the normal populations (4.8％) (P<0.05)，and also was much higher than the population with HPV-DNA positive(19.47％)(P<0.05). Conclusion The combined test of TCT and PHV contributes greatly to the early diagnosis of CIN,and TCT combined with HPV is the optial choice for screening of early cervical lssion and cervical cancer.

Key words: Gynecological general survey, Cervical carcinoma, Human papillomavirus, Thinprep cytologic test, Colposcopy