兩癌篩查系統(tǒng)的檢查項目與特點

　　兩癌篩查系統(tǒng)（針對宮頸癌與乳腺癌）是通過系統(tǒng)化檢查實現(xiàn)早期發(fā)現(xiàn)、早期診斷的健康保障體系，其檢查項目兼顧精準性與普適性，特點鮮明，在女性健康管理中發(fā)揮著關(guān)鍵作用。

　　The two cancer screening system (for cervical cancer and breast cancer) is a health security system that realizes early detection and early diagnosis through systematic examination. Its examination items give consideration to accuracy and universality, with distinctive characteristics, and play a key role in women's health management.

　　宮頸癌篩查項目注重階梯式排查。首先進行宮頸細胞學(xué)檢查（巴氏涂片或液基薄層細胞學(xué)檢測），采集宮頸脫落細胞，通過顯微鏡觀察細胞形態(tài)，判斷是否存在異常增生或癌變傾向，液基檢測的細胞保存更完整，異常細胞檢出率比傳統(tǒng)巴氏涂片提高 20% 以上。若細胞學(xué)檢查發(fā)現(xiàn)異常，需進一步做 HPV（人乳頭瘤病毒）檢測，因為 90% 以上的宮頸癌與高危型 HPV 持續(xù)感染相關(guān)，檢測可明確病毒亞型（如 HPV16、18 型為高危中的高危），為后續(xù)干預(yù)提供依據(jù)。對于 HPV 陽性或細胞學(xué)結(jié)果可疑者，需通過陰道鏡檢查放大宮頸組織，在可疑區(qū)域取活檢，經(jīng)病理診斷確認是否癌變，形成 “細胞學(xué) / HPV 檢測 — 陰道鏡 — 病理” 的三級篩查鏈條，逐步提升診斷精準度。

　　The cervical cancer screening program focuses on a step-by-step screening approach. Firstly, cervical cytology examination (Pap smear or liquid based thin-layer cytology) is performed to collect cervical exfoliated cells. The morphology of the cells is observed under a microscope to determine whether there is an abnormal proliferation or cancer tendency. Liquid based examination preserves the cells more completely, and the detection rate of abnormal cells is increased by more than 20% compared to traditional Pap smear. If abnormalities are found in cytological examination, further HPV (human papillomavirus) testing is required, as over 90% of cervical cancers are associated with persistent infection with high-risk HPV types. Testing can identify virus subtypes (such as HPV16 and 18, which are considered high-risk) and provide a basis for subsequent interventions. For individuals who are HPV positive or have suspicious cytological results, it is necessary to enlarge cervical tissue through colposcopy examination, take biopsy from the suspicious area, and confirm whether there is cancer through pathological diagnosis, forming a three-level screening chain of "cytology/HPV testing - colposcopy - pathology", gradually improving diagnostic accuracy.

　　乳腺癌篩查項目結(jié)合影像與臨床檢查?；A(chǔ)項目為乳腺觸診，醫(yī)生通過手法檢查乳房有無腫塊、乳頭溢液、皮膚凹陷等異常體征，操作簡便且無創(chuàng)傷，適合大規(guī)模初篩。影像檢查中，乳腺超聲是常用手段，能清晰顯示乳腺組織層次，區(qū)分囊性與實性腫塊，對致密型乳腺（年輕女性常見）的檢查敏感性優(yōu)于鉬靶。40 歲以上女性或高危人群（如家族乳腺癌史）需加做乳腺鉬靶檢查，通過低劑量 X 線成像，可發(fā)現(xiàn)超聲難以識別的微小鈣化（乳腺癌早期常見表現(xiàn)），兩種影像手段結(jié)合能將早期檢出率提升至 85% 以上。對于疑似病例，需進行乳腺磁共振（MRI）檢查，其軟組織分辨率更高，可評估病變范圍及血供情況，為活檢或手術(shù)方案提供參考。

　　Breast cancer screening program combines imaging and clinical examination. The basic project is breast palpation, where doctors use manual examination to check for abnormal signs such as lumps, nipple discharge, and skin depressions in the breast. The operation is simple and non-invasive, suitable for large-scale initial screening. In imaging examination, breast ultrasound is a commonly used method that can clearly display the hierarchy of breast tissue, distinguish cystic and solid masses, and has better sensitivity than mammography for dense breast (common in young women). Women over 40 years old or high-risk groups (such as family history of breast cancer) need additional mammography. Through low-dose X-ray imaging, small calcifications that are difficult to identify by ultrasound (common early manifestations of breast cancer) can be found. The combination of two imaging methods can increase the early detection rate to more than 85%. For suspected cases, breast magnetic resonance imaging (MRI) examination is required, which has higher soft tissue resolution and can evaluate the extent of lesions and blood supply, providing reference for biopsy or surgical plans.

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