Sankaranarayanan Rengaswamy, Shastri Surendra S, Basu Parthasarathi, Mahé Cédric, Mandal Ranajit, Amin Geethanjali, Roy Chinmayi, Muwonge Richard, Goswami Smriti, Das Pradip, Chinoy Roshini, Frappart Lucien, Patil Sharmila, Choudhury Devjani, Mukherjee Titha, Dinshaw Ketayun
Unit of Descriptive Epidemiology, International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France.
Cancer Detect Prev. 2004;28(5):345-51. doi: 10.1016/j.cdp.2004.04.004.
Several studies have investigated the accuracy of naked eye visual inspection with acetic acid (VIA) in the early detection of cervical neoplasia. It is not clear whether low-level (2-4x) magnification (VIAM) can improve the sensitivity and specificity of VIA. The accuracy of both VIA and VIAM, provided by independent health workers, were evaluated in three cross-sectional studies involving 18,675 women aged 25-65 years in Kolkata and Mumbai in India. All screened women were investigated with colposcopy and biopsies were obtained based on colposcopy findings. The final disease status was based on the reference standard of histology (if biopsies had been taken) or colposcopy. Data from the studies were pooled to calculate the test characteristics for the detection of high-grade squamous intraepithelial lesions (HSIL). 14.1% and 14.2% were positive on testing with VIA and VIAM respectively. Two hundred twenty-nine were diagnosed with HSIL and 68 with invasive cancer. The pooled sensitivity, specificity, positive and negative predictive values for VIA in detecting high-grade squamous intraepithelial lesions (HSIL) were 60.3% (95% CI: 53.6-66.7), 86.8% (95% CI: 86.3-87.3), 5.9% (95% CI: 5.0-7.0), and 99.4% (95% CI: 99.2-99.5), respectively. The values were 64.2% (95% CI: 57.6-70.4), 86.8% (95% CI: 86.2-87.3), 6.3% (95% CI: 5.3-7.3) and 99.4% (95% CI: 99.3-99.6), respectively, for VIAM. Low-level magnification did not improve the test performance of naked eye visualization of acetic acid impregnated uterine cervix.
多项研究调查了乙酸肉眼视诊（VIA）在早期检测宫颈肿瘤方面的准确性。尚不清楚低倍（2 - 4倍）放大（VIAM）是否能提高VIA的敏感性和特异性。在印度加尔各答和孟买开展的三项横断面研究中，对由独立卫生工作者进行的VIA和VIAM的准确性进行了评估，研究涉及18675名年龄在25至65岁的女性。所有接受筛查的女性均接受了阴道镜检查，并根据阴道镜检查结果进行活检。最终疾病状态基于组织学参考标准（如果已进行活检）或阴道镜检查。汇总这些研究的数据以计算检测高级别鳞状上皮内病变（HSIL）的检测特征。VIA和VIAM检测的阳性率分别为14.1%和14.2%。229例被诊断为HSIL，68例为浸润癌。VIA检测高级别鳞状上皮内病变（HSIL）的汇总敏感性、特异性、阳性预测值和阴性预测值分别为60.3%（95%CI：53.6 - 66.7）、86.8%（95%CI：86.3 - 87.3）、5.9%（95%CI：5.0 - 7.0）和99.4%（95%CI：99.2 - 99.5）。VIAM的相应值分别为64.2%（95%CI：57.6 - 70.4）、86.8%（95%CI：86.2 - 87.3）、6.3%（95%CI：5.3 - 7.3）和99.4%（95%CI：99.3 - 99.6）。低倍放大并未改善乙酸浸渍宫颈的肉眼观察检测性能。
