Misra J S, Das K
Department of Obstetrics and Gynaecology, K.G. Medical College, Lucknow, India.
Diagn Cytopathol. 1998 Nov;19(5):344-8. doi: 10.1002/(sici)1097-0339(199811)19:5<344::aid-dc6>3.0.co;2-f.
The study was aimed at clinically downstaging cancer of the cervix during a cytological Screening Programme to find out whether such a strategy may help in yielding a large number of early cases of cancer. A cohort of 6,178 women with different cervical lesions were cytologically examined from April 1971 at Queen Mary's Hospital, Lucknow, India. The 8,718 asymptomatic women with healthy cervices were taken as controls. The incidence of cervical dysplasia and malignancy in the study group was found to be 11.2% and 1.9%, which was statistically highly significant compared to control values of 3.3% and 0.02%, respectively. Dysplastic smears were seen maximally in women whose cervix bled to the touch, and the rate of cervical cancer was high in women with suspicious cervix. Dysplastic smears were seen frequently in all age and parity groups, but malignancy was common in women of high age (over 30 years) and high parity (two and above). The incidence of three sexually transmitted diseases, namely Trichomonas vaginalis, Herpes simplex, and condyloma revealed highly significant values, especially in women whose cervix bled to the touch. The study highlights the strategy of clinically downstaging cervical cancer, which is very useful in detecting a large number of dysplasia and frank malignancy cases and also the presence of any associated sexually transmitted pathogens whose treatment would aid in restricting the rising incidence of the dreaded disease in this country.
该研究旨在通过一项细胞学筛查计划对宫颈癌进行临床降期，以确定这种策略是否有助于发现大量早期癌症病例。1971年4月起，在印度勒克瑙的玛丽皇后医院对6178名患有不同宫颈病变的女性进行了细胞学检查。将8718名宫颈健康的无症状女性作为对照。研究组中宫颈发育异常和恶性肿瘤的发生率分别为11.2%和1.9%，与对照组分别为3.3%和0.02%的值相比，在统计学上具有高度显著性。触诊时宫颈出血的女性中发育异常涂片最为常见，宫颈可疑的女性中宫颈癌发生率较高。在所有年龄和产次组中均经常见到发育异常涂片，但恶性肿瘤在高龄（30岁以上）和高孕次（二胎及以上）女性中较为常见。三种性传播疾病，即阴道毛滴虫、单纯疱疹和尖锐湿疣的发生率显示出高度显著性，尤其是在触诊时宫颈出血的女性中。该研究突出了宫颈癌临床降期的策略，这对于检测大量发育异常和明显恶性肿瘤病例以及发现任何相关的性传播病原体非常有用，对这些病原体的治疗将有助于限制该国这种可怕疾病不断上升的发病率。
