陈丽梅

摘 要 宫颈癌是中国女性第二常见的癌症类型，却是可通过早期筛查予以彻底防治的癌症。及早进行宫颈癌筛查可有效防治宫颈癌。随着对宫颈癌发病机制认识的不断深入，宫颈癌筛查相关的检测方法也在不断发展，从最初的细胞学检查到分子生物学检测、生物标志物检测，检测的敏感性和特异性不断提高。同时，宫颈癌筛查相关的指南也不断完善并在发达国家或地区得到了有效的推广。相应地，这些国家或地区的宫颈癌防治水平亦得到了大幅提高。本文就宫颈癌筛查技术发展及最新筛查指南作一概述。

关键词 宫颈癌 筛查 人乳头瘤病毒 生物标志物

中图分类号：R737.33 文献标识码：A 文章编号：1006-1533（2018）01-0003-05

Advances in cervical cancer screening techniques and guidelines

CHEN Limei*（Medical Center of Diagnosis and Treatment for Cervical Diseases， Obstetrics & Gynecology Hospital of Fudan University， Shanghai 200011， China）

ABSTRACT Cervical cancer ranks the second most comman malignancy in Chinese women， and is a cancer that can be thoroughly controlled by early screening. Cervical cancer can be effectively prevented and treated by early screening. The detective methods for screening of cervical cancer have been developing with the deepen understanding of the pathogenesis of cervical cancer and their sensitivity and specificity have been improved from the initial cytology testing to molecular biology methods and biomarker detection. Meanwhile， the guidelines for the screening of cervical cancer have been also improved and effectively implemented in the developed countries or regions， in which the prevention and control of cervical cancer have also been greatly improved. The latest advances in the screening technology of cervical cancer and the relative guidelines are summarized in this article.

KEY WORDS cervical cancer； screening； human papillomavirus； biomarkers

宮颈癌是严重危害妇女生命健康的癌症，是全球女性的第四常见癌症类型，全球每年新发病例数为52.8万人，死亡病例数为26.6万人[1]。在中国，宫颈癌每年的新发病例数为9.89万人，死亡3.05万人[2]。宫颈癌在中国15 ～ 44岁女性各癌症发病率中居第二位，死亡率居第三位[3]。

虽然宫颈癌是癌症，但并不是不能治愈的绝症。宫颈癌是目前唯一病因明确的癌症，也是唯一可通过早期筛查、早期发现、彻底防治的癌症。宫颈癌特有的发病机制决定了对其可实现“早发现、早干预、早治疗”。持续感染高危型人乳头瘤病毒（human papillomavirus， HPV）可导致宫颈癌前病变及浸润癌。大多数女性一生中都会感染HPV，但不是所有感染HPV的女性都会发展至癌前病变或宫颈癌。90%以上的感染会在2年内被机……