机会性筛查对非洲马里宫颈癌的应用研究

目的 对非洲马里女性进行基础信息调查,分析2种筛查技术对宫颈癌及宫颈癌前病变(cervical intraepithelial neoplasia,CIN)在非洲马里应用的筛查效果,为提高宫颈癌及宫颈癌前病变筛查技术的质量提供数据支持和科学依据。 方法 选择2016年6月—2018年6月3 658例女性作为筛查对象,符合条件女性为3 638例。用双肓法分别做醋酸染色目视观察法(visual inspection with acetic acid,VIA)/Lugol碘染色目视观察法(visual inspection with Lugol's iodine,VILI)和细胞学2种筛查技术,筛查阳性或临床可疑女性实行阴道镜下病理活检。 结果 在3 638例参加筛查女性中,首次性交年龄为(18.19±3.26)岁,生育胎次为(4.5±3.1)胎,一夫多妻构成比为50.27%,小学及以下文化程度为48.87%,认知率为13.20%;VIA/VILI组CINⅡ+病变检出率为4.90%(χ2=14.241,P=0.014),细胞学组CINⅡ+病变检出率为5.16%(χ2=17.189,P=0.004);病理活检检出率为74.53%。 结论 加强宫颈癌预防知识的宣传,提高对宫颈癌的认知率和筛查率,规范筛查方案,对于降低非洲马里宫颈癌的发病率和死亡率具有重要的社会意义。 

Application of opportunistic screening for cervical cancer in Mali

Objective To conduct the basic information investigation to women in Mali, evaluate the effectiveness of visual inspection with acetic acid(VIA) & visual inspection with Lugol's iodine(VILI) method and cytology method for cervical cancer and cervical intraepithelial neoplasia(CIN), and provide data support and scientific evidence for the improvement of screening techniques. Methods A total of 3 658 cases of women from 2016 to 2018 were selected as screening objects, and 3 638 cases were eligible women. The visual inspection with acetic acid(VIA) & visual inspection with Lugol's iodine(VILI) and the cytology method were respectively performed under double-blind experiment. The colposcopy was conducted in women with a positive result or clinically possible patients for the cervical biopsy. Results Among the 3 638 women who participated in the screening, the age of first sexual intercourse was 18.19±3.26 years old, the number of births was 4.5±3.1, the ratio of polygamy was 50.27%, the education level of primary school or below was 48.87%, and the recognition rate was 13.20%. The detection rate of CINⅡ+ lesions in VIA/VILI group was 4.90%(χ2=14.241, P=0.014), and the detection rate of CINⅡ+ lesions in cytology group was 5.16%(χ2=17.189, P=0.004). Meanwhile, the detection rate of pathological biopsy was 74.53%. Conclusion It is significantly important to strengthen the awareness of cervical cancer prevention knowledge, improve the cognition rate and screening rate of cervical cancer, and standardize screening programs to reduce the morbidity and mortality of cervical cancer in Mali, Africa.