醋酸肉眼观察法在基层宫颈癌筛查的应用研究

目的 探讨在基层开展醋酸肉眼观察、阴道镜检查和病理活检取材进行宫颈癌筛查和早诊早治的可行性.方法 采取整群抽样的方法,对4 036例山西省某县两个镇全部30～60岁的已婚妇女进行醋酸肉眼观察和碘染色肉眼观察,并对可疑者进行阴道镜检查及病理活检.结果 醋酸肉眼观察异常/可疑和/或碘染色肉眼观察异常的病例共计345例(8.5%).对上述病例进行阴道镜检查,结果显示低度病变的337例,高度病变7例,宫颈浸润癌1例.组织活检病理结果显示慢性宫颈炎272例(78.8%),宫颈上皮内瘤样病变共73例(20.8%).结论 醋酸肉眼观察和碘染色肉眼观察的筛查结果可互为补充,建议两者联合应用,以提高筛查的灵敏度和特异度;在我国广大农村经济欠发达地区应用醋酸肉眼观察/碘染色肉眼观察法初筛宫颈癌是可行的.

Application of VIA in screening of cervical carcinoma in local hospitals

Objective To explore feasibilities of applications of visual inspection with acetic acid (VIA), colposcopy and pathological biopsy in screening, early diagnosis and early treatment of cervical carcinoma in local hospitals. Methods In cluster sampling method, 4 036 married women aged 30~60 years from 2 towships of a county of Shanxi province were screened for cervical carcinoma by using VIA and visual inspection with Lugol's iodine (VILI). Those abnormal women received colposcopy and biopsy. Results 345 women (8.5%) were abnormal or suspicious by VIA and/or VILI. All the abnormal women received colposcopy and biopsy. The results of colposcopy showed that 337 cases were low-grade lesions, 7 cases were high-grade lesions and 1 case was invasive cervical carcinoma. The results of pathological biopsy showed that 272 cases (78.8%) were chronic cervicitis and 73 cases (20.8%)were CIN. Conclusion The screening results by VIA and VILI can complemented each other. It is recommended that the two methods can be used together to improve sensitivity and specificity of screening of cervical carcinoma. Combined applications of VIA and VILI in preliminary screening of cervical carcinoma in undeveloped rural areas is feasible.