醋酸碘染色法联合阴道镜对非洲马里女性宫颈癌的筛查效果

目的 评价醋酸/碘染色法(VIA/VILI)联合阴道镜对非洲马里女性宫颈癌及其癌前病变的筛查效果。方法选取2015年8月至2018年8月3657例符合条件的非洲马里女性,采用VIA/VILI和阴道镜下病理活检筛查技术开展宫颈癌筛查,评价该技术的初筛效果和宫颈上皮瘤变中度(CIN2)+病变检出效果。结果 每个年龄段女性对宫颈癌筛查的积极率不同,随着年龄的增加,其积极率也随之降低;VIA/VILI和病理活检的调整CIN2+病变检出率分别为1.89%、2.16%;VIA/VILI的筛查阳性率随着年龄增长下降较为平缓,而阴道镜下病理活检结果筛查阳性率随着年龄的增长逐渐增长;敏感度、特异度、阳性预测值、阴性预测值、准确性及约登指数分别为84.81%、85.35%、11.34%、99.61%、85.34%及0.70%;筛查人群的首次性交平均年龄为(17.78±2.93)岁,一夫多妻占54.50%,既往宫颈筛查占3.91%,女性行割礼术占90.37%,该人群中小学及以下文化程度的女性占70.19%。结论 应用VIA/VILI筛查宫颈癌前病变有较高敏感度、特异性,但在应用和推广中存在一定的局限性、主观性,应予以重视。

Screening effect of iodine acetate staining combined with colposcopy on cervical cancer in African Mali women

Objective To evaluate the screening effect of acetic acid/iodine staining(VIA/VILI) combined with colposcopy on cervical cancer and precancerous lesions in African Mali women.Methods A total of 3657 eligible African Malian women from August 2015 to August 2018 were selected.The VIA/VILI and colposcopy pathological biopsy screening technology was used to conduct cervical cancer screening.The initial screening effect and detection effect of moderate neoplasia (CIN2)+lesion of cervical intraepithelial neoplasia by this technology were evaluated.Results The positive rate of cervical cancer screening varies among women of each age group.As the age increased,the positive rate decreased.The adjusted CIN2+lesion detection rate by VIA/VILI and pathological biopsy was 1.89% and 2.16%,respectively.The positive rate of screening by VIA/VILI decreased gradually with age,and the positive rate of pathological biopsy results under colposcopy gradually increased with age.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Yoden indexes were 84.81%,85.35%,11.34%,99.61%,85.34% and 0.70%.The average age of first sexual intercourse in the screened population was(17.78±2.93) years,with polygamy accounting for 54.50%,previous cervical screening 3.91%,and female circumcision 90.37%.70.19% of the females had primary and secondary schools.Conclusion The application of VIA/VILI for screening cervical precancerous lesions has high sensitivity and specificity,but there are certain limitations and subjectivity in the application and promotion,which should be paid attention to.