Li Chang-dong, Zhang Wei-yuan, Zhang Song-wen, Wu Ming-hui, Wang Jian-dong
Beijing Obstetrics & Gynecology Hospital affiliated to Capital Medical University, Beijing 100026, China.
Zhonghua Yi Xue Za Zhi. 2010 Jan 19;90(3):196-200.
To investigate the characteristic of precancerous conditions of cervical intraepithelial neoplasia (CIN) and its related high-risk factors among the married women in Beijing, China.
Based upon the method of cross-sectional survey, 6339 married women at reproductive age from 25 to 54 years old were selected randomly in a total of 137 communities of 12 districts or counties in Beijing from March 2007 to September 2008. The interview was carried out with unified questionnaires and gynecological examinations. And the cervical Pap smear was used for liquid-based cytological examination and the cervical secretion for detection of high-risk human papillomavirus (HPV) DNA. Furthermore, the women with abnormal cervical cytology received colposcopy and cervical biopsy.
(1) Among 6, 339 study subjects, 374 cases had CIN and the prevalence rate was 5.9%; (2) For the cases with cervical cytology positive results, cervical biopsy showed an elevated level of abnormal cytology and an increased incidence of cervical lesions; (3) The peak age of CIN prevalence was 30 to 34 years old and there was a high grade of cervical neoplasia; (4) Among the population, the infection rate of high-risk HPV was 9.9% and the infection rate of high-risk HPV in positive cytological group (41.2%) was significantly higher than that in negative cytological group (6.6%); (5) The infection rate and DNA load of high-risk HPV increased following the severity grade of CIN.
In Beijing, married women at 30 to 34 years old are the high-risk group in CIN incidence and the infection of high-risk HPV is an independent risk factor. Liquid-base cytology combined with high-risk HPV DNA test is a viable method to discover CIN in time and prevent the incidence of cervical cancer.
探讨中国北京已婚女性宫颈上皮内瘤变（CIN）癌前病变特征及其相关高危因素。
采用横断面调查方法，于2007年3月至2008年9月在北京12个区县的137个社区中随机选取6339名25至54岁的已婚育龄妇女。采用统一问卷进行访谈并进行妇科检查。宫颈巴氏涂片用于液基细胞学检查，宫颈分泌物用于检测高危人乳头瘤病毒（HPV）DNA。此外，宫颈细胞学异常的女性接受阴道镜检查和宫颈活检。
（1）在6339名研究对象中，374例患有CIN，患病率为5.9%；（2）宫颈细胞学检查结果为阳性的病例，宫颈活检显示细胞学异常水平升高，宫颈病变发生率增加；（3）CIN患病率的高峰年龄为30至34岁，且存在高级别宫颈肿瘤；（4）人群中高危HPV感染率为9.9%，细胞学阳性组高危HPV感染率（41.2%）显著高于细胞学阴性组（6.6%）；（5）高危HPV的感染率和DNA载量随CIN严重程度分级增加。
在北京，30至34岁的已婚女性是CIN发病的高危人群，高危HPV感染是独立危险因素。液基细胞学联合高危HPV DNA检测是及时发现CIN、预防宫颈癌发生的可行方法。
