Cecchini S, Iossa A, Bonardi R, Gustavino C, Ciatto S
Centro per lo Studio e la Prevenzione Oncologica, Florence, Italy.
Tumori. 1992 Jun 30;78(3):211-3. doi: 10.1177/030089169207800313.
Cervicography was performed in 606 women referred for colposcopy. Cervigrams were blindly reviewed by two independent readers. The positivity rate at cervicography was high (operator A = 50%, B = 58.8%). The sensitivity for papillomavirus infection (HPV)/cervical intraepithelial neoplasia I (CIN I) (n = 141) was 79.4% for operator A and 80.8% for operator B. The sensitivity for CIN II or more severe lesions (n = 22) was 95.2% and 90.5% for operators A and B, respectively. The positive predictive value for HPV/CIN I or CIN II, or more severe lesions was 36.9% and 6.9% for operator A and 32.1% and 5.3% for operator B, respectively. Interobserver variability was acceptable (kappa = 0.62). Cervicography suspected 27 HPV/CIN I, 1 CIN II and 1 CIN III which showed no cytologic abnormalities. This study confirms that cervicography has a good sensitivity for cervical lesions, but it is based on a selected series, not representative of a screening condition. The combination of cervicography and cytology in screening is presently under evaluation in a prospective study of screened women.
对606名转诊接受阴道镜检查的女性进行了宫颈造影。两名独立阅片者对宫颈造影图像进行盲法评估。宫颈造影的阳性率较高（操作者A为50%，操作者B为58.8%）。对于人乳头瘤病毒感染（HPV）/宫颈上皮内瘤变I级（CIN I）（n = 141），操作者A的敏感度为79.4%，操作者B为80.8%。对于CIN II级或更严重病变（n = 22），操作者A和B的敏感度分别为95.2%和90.5%。对于HPV/CIN I级或CIN II级及更严重病变，操作者A的阳性预测值分别为36.9%和6.9%，操作者B分别为32.1%和5.3%。观察者间的一致性可接受（kappa = 0.62）。宫颈造影怀疑有27例HPV/CIN I级、1例CIN II级和1例CIN III级，这些病例无细胞学异常表现。本研究证实宫颈造影对宫颈病变具有良好的敏感度，但该研究基于一个特定的队列，不能代表筛查情况。目前正在对筛查女性进行一项前瞻性研究，评估宫颈造影与细胞学检查联合用于筛查的效果。
