国际妇产科学杂志

国际妇产科学杂志 ›› 2010, Vol. 37 ›› Issue (5): 370-372.

• 论著 • 上一篇    下一篇

醋酸-碘试验在宫颈癌早期筛查中的价值

李洁,赵树旺,崔丽阳,樊婷婷,岳天孚,张丽琴,乔友林,魏丽惠   

  1. 300270 天津市大港医院妇产科（李 洁，赵树旺，崔丽阳，樊婷婷）；天津医科大学总医院妇产科（岳天孚，张丽琴）；中国医学科学院肿瘤研究所（乔友林）；北京大学人民医院妇产科（魏丽惠）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2010-10-15 发布日期:2010-10-15

LI Jie, ZHAO Shu-wang, CUI Li-yang, FAN Ting-ting, YUE Tian-fu, ZHANG Li-qin, QIAO You-lin, WEI Li-hui.   

  1. Tianjin Dagang Hospital, Tianjin 300270, China （LI Jie, ZHAO Shu-wang, CUI Li-yang, FAN Ting-ting）; General Hospital of Tianjin Medical University，Tianjin 300052, China（YUE Tian-fu, ZHANG Li-qin）; Cancer Institute, Chinese Academy of Medical Sciences, Beijing
  • Received:1900-01-01 Revised:1900-01-01 Published:2010-10-15 Online:2010-10-15

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摘要： 目的：评价宫颈醋酸－碘试验（VIA-VILI）筛查宫颈癌早期病变的价值。方法：2008年5月—9月对天津市大港区迎新街社区的2 006例30~59岁有性生活妇女进行宫颈癌早期病变筛查。采集宫颈脱落细胞留做薄层液基细胞学（LCT）检测。然后应用5%醋酸及希乐液涂抹法进行VIA-VILI，VIA-VILI阴性而LCT结果异常者、VIA阳性者或VILI阳性者行阴道镜检查及活检病理检查。结果：最终有2 000例纳入试验，VIA-VILI阳性并取活检347例，病理结果显示≥CINⅡ者47例（占13.54%）；LCT阳性并取活检134例，病理结果显示≥CINⅡ的50例（37.31%），其中39例为VIA-VILI及LCT均为阳性者。筛查CINⅡ及以上宫颈病变和宫颈癌的敏感度、特异度和约登指数，VIA-VILI方法分别为81%、84.6%和0.656，LCT检查分别为90.3%、88.4%和0.787。结论：VIA-VILI试验筛查宫颈病变的效率虽低于LCT检查，但方便快捷、价格低廉，在经济不发达地区或低收入人群中有一定应用价值。

关键词: 宫颈肿瘤, 宫颈上皮内瘤样病变, 阴道涂片, 细胞诊断学, 敏感性与特异性

Abstract: Objective: To evaluate the value of visual inspection with acetic acid（VIA）-visual inspection with Lugol’s iodine（VILI） in the early screening of cervical cancer. Methods: From May 2008-September 2008, 2 006 women having sexual life who are 30-59 years old were screened for the early lesions of cervical cancer in the community of Yingxin Street, in Dagang Disctrict, Tianjin. Cervical cells were collected and kept for LCT test. Then, apply 5% acetic acid and use the liquid coating method for VIA-VILI. The patients whose VIA-VILI were negative while the LCT were abnormal, and whose VIA or VILI were positive were done colposcopy examination and biopsy. Results: Finally, 2 000 people were brought into the test and 347 of them were diagnosed to be positive in VIA-VILI and were done biopsy, according to pathology, 47 people（13.54%） were equal or more than CIN Ⅱ. Meanwhile, 134 people were diagnosed to be positive in LCT and 50 people（37.31%） were equal or more than CIN Ⅱ based on pathology, and there were 39 people who were both been tested to be positive in VIA-VILI and LCT. The result of using VIA-VILI method to screen CIN Ⅱ and the sensitivity, specificity and some board index of cervical lesions and cervical cancer mentioned above were 81%, 84.6%, and 0.656 respectively. At the same time the result of using liquid based cytology method to screen them were 90.3%, 88.4%, and 0.787 respectively. Conclusions: Although the efficiency of using VIA-VILI test to screen cervical disease is lower than using liquid based cytology test, VIA-VILI test is cheap, convenient and fast, it is valuable for underdeveloped areas and lower-income people.

Key words: Uterine cervical neoplasms, Cervical intraepithelial neoplasia, Vaginal smears, Cytodiagnosis, Sensitivity and specificity