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BMJ:宫颈癌筛查到底哪种方法好?

2017-02-14 xing.T MedSci原创

这些发现应该引起对检测渐进性宫颈上皮内瘤变敏感性相似的不同类型液基细胞学和常规细胞学检查的重新考虑。

近日,顶级杂志BMJ上发表了一篇研究文章,研究人员旨在比较通过常规细胞学和液基细胞学检查SurePath和ThinPrep筛查正常的个体在筛查后72个月被诊断为宫颈癌的累计发病率。

该研究采用以人群为基础的回顾性队列研究,在2000年1月至2013年期间,以荷兰全国性网络和组织和细胞病理学注册中心为基础。 研究以5924474名筛查样本正常妇女为基础(23833123人次每年)。研究人员采用液基细胞学检查SurePath或ThinPrep与传统细胞学作为筛选试验进行比较。该研究的主要结局指标为每种筛查方法筛查正常的个体在筛查后72个月发生浸润性宫颈癌的累积发病率。研究人员采用Cox回归分析评估了风险比,调整了日历时间、年龄、筛查史以及社会经济地位,并且纳入了实验室作为随机效应。

研究人员发现通过常规细胞学筛查正常的个体72个月后宫颈癌的累计发病率为58.5(95%可信区间54.6- 62.7)每100000人,相比于ThinPrep为66.8(56.7-78.7),而SurePath为44.6(37.8-52.6)。与传统的细胞学检查相比,SurePath筛查浸润性宫颈癌的风险降低了19%(风险比为0.81,95%可信区间为0.66-0.99),主要是由于临床检测的宫颈癌风险降低了27%(0.73,0.57-0.93)。对于ThinPrep来说,风险平均高出15%(风险比为1.15,0.95-1.38),主要由于筛查检测的宫颈癌风险增加了56%(1.56,1.17-2.08)。

这些发现应该引起对检测渐进性宫颈上皮内瘤变敏感性相似的不同类型液基细胞学和常规细胞学检查的重新考虑。

原始出处:

Kirsten Rozemeijer, et al. Cervical cancer incidence after normal cytological sample in routine screening using SurePath, ThinPrep, and conventional cytology: population based study.BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j504

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    2017-11-11 gaoxiaoe
  2. 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    2017-02-17 天涯183

    很不错的文章

    0

  3. 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    2017-02-16 一闲
  4. 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topicName=宫颈癌筛查)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b0415457691, createdName=般若傻瓜, createdTime=Thu Feb 16 12:20:00 CST 2017, time=2017-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176405, encodeId=1b681e640590, content=大洋本量的研究啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=071c2012037, createdName=wmu姿, createdTime=Thu Feb 16 08:57:46 CST 2017, time=2017-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176225, encodeId=3b701e622500, content=学习并收藏了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Wed Feb 15 07:52:37 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176191, encodeId=a85e1e619151, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Wed Feb 15 06:54:46 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176187, encodeId=48a51e6187bc, content=认真拜读啦!学习一下,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160916/IMG57DBEDBBA66BD2947.jpg, createdBy=3b181951777, createdName=ren1mw, createdTime=Wed Feb 15 06:02:40 CST 2017, time=2017-02-15, status=1, ipAttribution=)]
    2017-02-16 wmu姿

    大洋本量的研究啊

    0

  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Wed Feb 15 07:52:37 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176191, encodeId=a85e1e619151, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Wed Feb 15 06:54:46 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176187, encodeId=48a51e6187bc, content=认真拜读啦!学习一下,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160916/IMG57DBEDBBA66BD2947.jpg, createdBy=3b181951777, createdName=ren1mw, createdTime=Wed Feb 15 06:02:40 CST 2017, time=2017-02-15, status=1, ipAttribution=)]
    2017-02-15 huangzh898

    学习并收藏了!

    0

  7. 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createdAvatar=https://img.medsci.cn/20230812/e93037ddfed9425fb0316dc3e904f2f4/870c0a4383ef42ef803173fea0339be3.jpg, createdBy=27ba1551982, createdName=huangzh898, createdTime=Wed Feb 15 09:26:17 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176222, encodeId=3f801e62223d, content=又涨知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55a22015915, createdName=1e1ff052m13(暂无匿称), createdTime=Wed Feb 15 09:10:13 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176202, encodeId=1e6f1e62023f, content=每一种检查方法都有它的局限性,但是在不断进步。, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Wed Feb 15 07:52:37 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176191, encodeId=a85e1e619151, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Wed Feb 15 06:54:46 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176187, encodeId=48a51e6187bc, content=认真拜读啦!学习一下,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160916/IMG57DBEDBBA66BD2947.jpg, createdBy=3b181951777, createdName=ren1mw, createdTime=Wed Feb 15 06:02:40 CST 2017, time=2017-02-15, status=1, ipAttribution=)]
    2017-02-15 1e1ff052m13(暂无匿称)

    又涨知识了

    0

  8. 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createdAvatar=https://img.medsci.cn/20230812/e93037ddfed9425fb0316dc3e904f2f4/870c0a4383ef42ef803173fea0339be3.jpg, createdBy=27ba1551982, createdName=huangzh898, createdTime=Wed Feb 15 09:26:17 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176222, encodeId=3f801e62223d, content=又涨知识了, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55a22015915, createdName=1e1ff052m13(暂无匿称), createdTime=Wed Feb 15 09:10:13 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176202, encodeId=1e6f1e62023f, content=每一种检查方法都有它的局限性,但是在不断进步。, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Wed Feb 15 07:52:37 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176191, encodeId=a85e1e619151, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Wed Feb 15 06:54:46 CST 2017, time=2017-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176187, encodeId=48a51e6187bc, content=认真拜读啦!学习一下,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160916/IMG57DBEDBBA66BD2947.jpg, createdBy=3b181951777, createdName=ren1mw, createdTime=Wed Feb 15 06:02:40 CST 2017, time=2017-02-15, status=1, ipAttribution=)]
    2017-02-15 邓启付

    每一种检查方法都有它的局限性,但是在不断进步。

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1848234, encodeId=47b0184823477, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sat Nov 11 04:20:00 CST 2017, time=2017-11-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=176614, encodeId=3eb01e661401, content=很不错的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, 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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160916/IMG57DBEDBBA66BD2947.jpg, createdBy=3b181951777, createdName=ren1mw, createdTime=Wed Feb 15 06:02:40 CST 2017, time=2017-02-15, status=1, ipAttribution=)]
    2017-02-15 milkshark

    值得学习

    0

  10. 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    2017-02-15 ren1mw

    认真拜读啦!学习一下,谢谢分享

    0

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