三种方法在鲁西南地区宫颈癌筛查中的可用性分析

目的 了解鲁西南地区的宫颈癌流行状况,比较3种流行筛查方法的优劣,为宫颈癌的防治提供依据.方法 鲁西南地区选取890名适龄妇女进行宫颈癌筛查,以阴道镜检查的病理组织学结果为金标准,比较巴氏涂片、液基细胞学、肉眼观察辅以醋酸白染色3种方法的可用性.结果 三种方法对宫颈上皮内高度病变的敏感度、特异度、阳性预测值、阴性预测值分别为:巴氏涂片:27.8％,87.5％,29.9％,98.1％；液基细胞学:79.6％,91.2％,38.4％,99.3％；肉眼观察辅以醋酸白染色:67.2％,78.5％,9.2％,99.6％.结论 液基细胞学的诊断价值最高,可作为首选的宫颈癌筛查方法；肉眼观察辅以醋酸白染色简单易行,适用于贫困地区的宫颈癌筛查工作.

Comparison of three methods for screening cervical cancer in Southeast Shandong Province

Objective To understand the prevalelnce of cervical cancer in southwest area of Shandong province and compare 3 popular screening tests for cervical cancer.Methods Totally 890 women in southwest area of Shandong were screened for cervical cancer,colposcopy histopathological findings were taken as a golden standard,the Pap smears,liquid-based cytology and naked eye observation supplemented by acetic acid white stain were used and compared.Results The sensitivity,specificity,positive predictive value and negative predictive value of Pap smears for screening cervical intraepithelial lesions were 27.8%,87.5%,29.9%,98.1%;that of liquid based cytology were 79.6%,91.2%,38.4%,99.3% and that of the naked eye observation supplemented by acetic acid white staining were 67.2%,78.5%,9.2%,99.6%.Conclusion Liquid-based cytology possessed the highest value for diagnosis and it can be used as the priority for cervical cancer screening,while macroscopic observation supplemented by acetic acid white staining is simple and suitable for cervical cancer screening in impoverished area.