[摘要] 目的 設计一种宫颈癌筛查风险评估量表，并对其可行性进行研究分析，为临床宫颈癌筛查提供指导性建议。方法 收集2015年12月～2016年6月就诊于安徽医科大学附属安庆医院妇科门诊的200例患者资料，其中宫颈良性病变组132例（宫颈炎症性疾病）和宫颈疾病组68例（宫颈上皮内瘤变和宫颈癌）。采用U检验和多因素Logistic回归分析法进行分析，经过分析筛选后，制定出“宫颈筛查风险评估量表”（CSRAS，L-Y-01）。最后另召集70名新的患者进行重新评估并验证该量表。 结果 本研究结果建立了一种新的宫颈筛查数字化模型，引出了12分的风险阈值。根据该模型，如果患者筛查总分值<12分，其最终的组织病理学检查结果更倾向为良性病变，从而可以避免有创性的检查和过度治疗；反之，如果总分值≥12分，则倾向为非良性病变，需转诊阴道镜进一步检查，可以降低因个别检查的假阴性或假阳性导致的误诊和漏诊。 结论 风险阈值可以用于宫颈疾病筛查的风险量化评估，且本实验的理念与现行的“风险量化、分层管理”的理念相符。
[关键词] 宫颈上皮内瘤变；宫颈癌；宫颈筛查；风险量化
[中图分类号] R73-3 [文献标识码] B [文章编号] 1673-9701（2016）34-0049-05
A feasibility study of cervical cancer screening risk assessment scale
YU Pengqiao1 LIU Shuai2 LI Qing1 WANG Yan1
1.Department of Obstetrics and Gynecology， Anqing Hospital Affiliated to Anhui Medical University， Anqing 246000，China； 2.Department of Emergency Medicine，Hefei First People "s Hospital Group Binhu Branch， Hefei 230032， China
[Abstract] Objective To design a Cervical Cancer Screening Risk Assessment Scale and analyze its feasibility，providing guidance for clinical cervical cancer screening. Methods A total of 200 cases of gynecological outpatients from Anqing Hospital Affiliated to Anhui Medical University from December 2015 to June 2016 were collected，including 132 cases of benign cervical lesions（cervical inflammatory diseases）and 68 cases of cervical diseases（Cervical intraepithelial neoplasia and cervical cancer）.The data were analyzed by the u-test and multivariate logistic regression analysis.After these independent variables were screened and analyzed， the Cervix Screening Risk Assessment Scale（CSRAS， L-Y-01） was developed.Finally， 70 new patients were eolled to reassess and validate the scale. Results The results of this study established a new digital model of cervical screening， which leads to a 12-point risk threshold.According to the model， if the total score of patient screening was <12 points， the final histopathological examination results tended to be benign lesions， which can avoid invasive examination and over-treatment. Conversely， if the total score of patient screening was≥12 points，the patient"s histopathological examination results tend to non-benign lesions， needing to refer to the colposcopy for further examination. The use of scales could reduce the misdiagnosis and missed diagnosis caused by false negative or false positives of individual inspection. Conclusion The risk threshold can be used to assess the risk of cervical disease screening， and the concept of this study is consistent with the current "risk quantification， hierarchical management" concept.