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实用预防医学 2010年第5期17卷 998-999页

作者：邱俊源李秀芳雷筝湖北省武汉市新洲区人民医院妇产科湖北武汉430400

目的探讨液基薄层细胞技术(TCT)和常规巴氏涂片预测早期宫颈癌的价值。方法对2006年1月-2008年12月在我院就诊的患者同时进行TCT检测和常规巴氏涂片进行细胞学诊断,对细胞学结果异常的168例患者行阴道镜下宫颈活检或行LEEP术组织病检。... 详细信息

目的探讨液基薄层细胞技术(TCT)和常规巴氏涂片预测早期宫颈癌的价值。方法对2006年1月-2008年12月在我院就诊的患者同时进行TCT检测和常规巴氏涂片进行细胞学诊断,对细胞学结果异常的168例患者行阴道镜下宫颈活检或行LEEP术组织病检。结果常规巴氏涂片细胞学结果为:低度鳞状上皮内病变(LSIL)109例,高度鳞状上皮内病变(HSIL)58例,鳞状细胞癌(SCC)1例;TCT检测细胞学结果为:低度鳞状上皮内病变(LSIL)94例,高度鳞状上皮内病变(HSIL)69例,鳞状细胞癌(SCC)5例;病检结果为:炎症或鳞状上皮化生25例,CINⅠ73例,CINII～III65例,SCC5例。TCT检测和常规巴氏涂片细胞学结果与组织病理比较,CINII-III的诊断符合率分别为92.75%、74.13%;鳞状细胞癌的漏检率分别为0、80%。两者比较差异有统计学意义(P常规巴氏涂片。

关键词：液基薄层细胞技术常规巴氏涂片早期宫颈癌

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维普期刊数据库

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一项国家标准推广前后的保健方案中衣原体的筛查

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世界核心医学期刊文摘（妇产科学分册） 2005年第12期1卷 60-61页

作者： Burstein G.R. Snyder M.H. Conley D. 党慧敏 Centers for Disease Control and Prevention Mail Stop E-80 1600 Clifton Road NE Atlanta GA 30333 United States Dr

Objective: To evaluate chlamydia-screening policies, testing practices, and the proportion testing positive in response to the new Health Plan Employer Data and Information Set (HEDIS) chlamydia-screening performance measure in a large commercial health plan. Methods: We interviewed health plan specialty departmental chiefs to describe interventions used to increase chlamydia screening and examined electronic medical records of 15- to 26- year- old female patients 37,438 from 1998 to 1999 and 37,237 from 2000 to 2001- who were classified as sexually active by HEDIS specifications to estimate chlamydia testing and positive tests 2 years before and after the HEDIS measure introduction. Results: In January 2000, the obstetrics and gynecology department instituted a policy to collect chlamydia tests at the time of routine Pap tests on all females 26 years old or younger by placing chlamydia swabs next to Pap test collection materials. Other primary care departments provided screening recommendations and provider training. During 1998- 1999, 57% of eligible female patients seen by obstetrics and gynecology exclusively and 63% who were also seen by primary care were tested for chlamydia; in 2000- 2001 the proportions tested increased to 81% (P < .001) and 84% (P < .001). Proportions tested by other primary care specialists did not increase substantially: 30% in 1998- 1999 to 32% in 2000- 2001. The proportion of females testing positive remained high after testing rates increased: 8% during 1998- 1999 and 7% during 2000- 2001, and the number of newly diagnosed females increased 10% . Conclusion: After the obstetrics and gynecology department introduced a simple systems-level change in response to the HEDIS measure, the proportion of females chlamydia-tested and number of newly diagnosed females increased.

关键词：常规巴氏涂片拭子电子病案检测规程专业部门

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人乳头瘤病毒检测作为宫颈癌低危妇女的初筛方法:希腊经验

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世界核心医学期刊文摘（妇产科学分册） 2005年第7期1卷 32-33页

作者： Agorastos T. Dinas K. Lloveras B. 王克芳 1st Univ. Clin. Obstet. and Gynecol. Aristotle University of Thessaloniki Hippokrateion Hospital 93 Plastira Street 55132 Thessaloniki Greece

Objective. To compare the performance of human papillomavirus (HPV) DNA detection against routine Papanicolaou smear for the detection of low- and high- grade cervical intraepithelial neoplasia in a low- risk population. Materials and methods. A cross- sectional study was performed involving 1296 women attending six outpatient clinics in Northern Greece (Thessaloniki, Thermi, Mihaniona, Corfu, Veria, and Serres). Women underwent a gynecological examination, including collection of exfoliated cervical cells for Papanicolaou cytology and HPV DNA detection. Cytology was processed according the conventional routine manner, and HPV DNA was determined using the polymerase chain reaction technique. In positive cases of either method, a complete colposcopic evaluation was performed with directed biopsies. Tests (HPV DNA, cytology, and colposcopy) performance characteristics were determined using the histopathologic diagnosis as the reference standard. Results. HPV DNA testing showed a significantly better sensitivity than the Papanicolaou smear in detecting cervical intraepithelial neoplasia (75% versus 50% for high- grade lesions and 81.2% versus 50% for lesions of any grade, respectively). Specificity, and positive and negative predictive values did not significantly differ. Even after dividing women in younger or older than 30 years, the sensitivity of the HPV DNA test was greater than cytology (100% and 70% versus 50% for cytology in both groups, respectively), with a 6.3% loss in specificity when performed in women younger than 30 years. Conclusion. HPV testing could be useful in screening women at low risk for cervical cancer, either as an adjunct tool to augment existing cytology programs or as a unique test of its own.

关键词：人乳头瘤病毒初筛方法巴氏细胞学检查常规巴氏涂片瘤样病变阴道镜阳性病例筛查手段巴氏涂片法 DNA

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