VIA＋VILI,宫颈细胞学联合宫颈癌初筛方法的比较

评价醋酸、碘液染色后直接肉眼观察、宫颈细胞学检查在宫颈癌筛查中的应用价值,为在现阶段宫颈癌高发且经济落后地区制定宫颈癌及其癌前病变的筛查方案提供依据。方法：在新疆喀什地区伽师县克孜勒博依乡筛查人群中,以病理组织学诊断结果为金标准,比较VIA,VILI,宫颈细胞学的筛查效果。结果：2600名当地妇女参与宫颈癌筛查,该人群宫颈高度鳞状上皮内病变及癌（≥CINⅡ）的现患率为0.615%（16/2600）,VIA阳性137例,阳性检出率5.15%,VILI阳性235例,阳性检出率9.04%,VIA＋VILI阳性262例,阳性检出率10.08%,1000名当地妇女进行巴氏涂片（TBS分类）,阳性45例,阳性检出率4.50%,VIA＋VILI联合初筛的阳性检出率明显高于醋酸染色后肉眼观察单项初筛,差异有统计学意义（P〈0.01）。巴氏涂片的阳性检出率低于VIA＋VILI联合筛查,差异有统计学意义（P〈0.01）。结论：VIA,VILI作为一种简便、廉价的检测手段,综合考虑设备需求和经济条件等原因,在经济落后地区,使用VIA,VILI进行子宫颈癌、癌前病变筛查是具有实用价值的初筛方法。

Comparison of VIA,VILI and Cervical Cytology in cervical cancer screeing program

Objective：To evaluate the value of visual inspection and cervical cytological screening after Acetic Acid Stain（VIA） and Lugol＇s iodine（V1Ll） in cervical cancer screening program,and to provide evidence for designing a cervical cancer screening algorithm in high risk areas of existing low - resource settings. Methods：Women in Kashgar Region were screened with VIA,VILI and cervical cytological screening,The efficacy of different screening tests was compared by the gold standard of pathology.Results：In the 2600 local women being screened,the pathological positive rate of HSI L,and CA（≥CINⅡ） were 0.615（16/2600 ）. The positive cases of VIA were 137（5.15%）,235（9.04%）positive cases of VILI,262 positive cases of VIA ＋ VILI.1000 women were screened with TBS,positive cases were 45（4.50%）.The positive result of VIA ＋ VILI was higher than the result of visual inspection with VIA（P0.01）.The positive result of TBS was lower than the result of VIA ＋ VILI（P0.01）.Conclusion：Regarding of equipments and economical reasons,VIA and VILI with simple and low cost are feasible screening methods for cervical cancer screening program,especially in the undeveloped areas.