肉眼观察法在宫颈癌及癌前病变筛查中的应用

目的：探讨醋酸肉眼观察（VIA）和碘染色肉眼观察（VILI）在宫颈癌及癌前病变筛查中的可行性。方法：以天津市大港区2 003例妇女为研究对象,进行癌症综合知识、危险因素的问卷调查,用VIA和 VILI行宫颈癌及其癌前病变筛查。VIA或VILI阳性者行电子阴道镜检查,阴道镜检查异常者行阴道镜下宫颈活检,病理学检查明确诊断。结果：单纯VIA阳性者257例,VIA或VILI阳性者共计265例,其中197例阴道镜检查异常,在阴道镜指导下行宫颈活检,以病理学检查结果作为诊断的金标准,宫颈上皮内瘤变（CIN）的检出率为7.04%,其中CINⅠ116例,CINⅡ14例,CINⅢ11例。结论：在资源有限、经济欠发达的地区,由经过培训的医生实施VIA或VILI做宫颈癌初筛的方案可行。

Application of Visual Inspection in Screening for Cervical Cancer and Precancerous Lesions

Objective: To explore feasibilities of visual inspection with acetic acid （VIA） and Lugol’s iodine （VILI） in screening for cervical cancer and precancerous lesions, and to find appropriate screening methods for cervical cancer as well as precancerous lesions in low resource areas in order to achieve early diagnose and early cure it, and to reduce incidence and mortality of cervical cancer eventually. Methods: In Dagang District of Tianjin, cervical cancer and precancerous lesions screening was done in 2 003 women. After consented and investigated using questionnaire （including knowledge of cancers and risk factors of cervical cancer）, they were examined by VIA and VILI and women who had positive results have received colposcopy. Women who had abnormal results by colposcopy have received biopsy and pathological diagnosis eventually. Results: 257 women were positive by VIA, and 265 were positive totally by VIA or VILI. These abnormal women received colposcopy, 197 cases of them showed abnormal in colposcopy and received biopsy. The pathological results showed that 7.04 percent of all the 2 003 women had cervical intraepithelial neoplasia.There were 116 cases had CINⅠ, 14 had CINⅡ, 11 had CINⅢ. Conclusion: VIA and VILI done by well trained doctors is a feasible screening method especially in the undeveloped areas. It will help to reduce the incidence and mortality of cervical cancer.