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[宫颈癌筛查项目中卢戈氏碘目视检查的评估]

[Evaluation on the visual inspection with Lugol's iodine in cervical cancer screening program].

作者信息

Li Ni, Ma Cong-ping, Sun Li-xin, Zhang Yong-zhen, Shao Shu-li, Xing Ju-xia, Bao Yan-ping, Huang Rui-de, He Li-ji, Qiao You-lin

机构信息

Department of Epidemiology, China Medical University, Shenyang 110001, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2006 Jan;27(1):15-8.

PMID:16737565
Abstract

OBJECTIVE

To evaluate visual inspection with Lugol's iodine (VILI) 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 to reduce the incidence and mortality of cervical cancer.

METHODS

Women in Yangcheng county, Shanxi province were screened with VILI, colposcopy, liquid-based cytology test and human papilloma virus (HPV) DNA test. The efficacy of different screening tests was compared by Youden's index based on the pathology as the gold standard.

RESULTS

In the population being screened, the mean age was 40.80 +/- 10.75 years old. Based on pathological findings, 4.35% (32/735) of the subjects had >or= CIN (cervical intraepithelial neoplasia) II. The sensitivity and specificity for the VILI test (>or= positive) were 53.13 and 82.19, while 56.25 and 79.09 were for colposcopy (>or= low grade dysplasia) respectively. Comparing by the Youden's indexs, there was no statistically significant difference (P > 0.05) between VILI and colposcopy. However, statistical significant difference (P < 0.05) was found between VILI and liquid-based cytology test and HPV DNA test. In addition, there was no statistically significant difference (P > 0.05) found between the experienced doctors and the newly-trained doctors working in the field station.

CONCLUSION

With low sensitivity when using microscope but low cost of equipments, VILI can be one of the primary screening tests in China's rural area with low-resource settings if the screening frequency is to be increased.

摘要

目的

评估卢戈氏碘液目视检查(VILI)在宫颈癌筛查项目中的效果,为在现有资源匮乏的高危地区设计宫颈癌筛查方案以降低宫颈癌发病率和死亡率提供依据。

方法

对山西省阳城县女性进行VILI、阴道镜检查、液基细胞学检测和人乳头瘤病毒(HPV)DNA检测筛查。以病理结果为金标准,采用约登指数比较不同筛查检测方法的效果。

结果

在被筛查人群中,平均年龄为40.80±10.75岁。根据病理结果,4.35%(32/735)的受试者患有≥CIN(宫颈上皮内瘤变)II级。VILI检测(≥阳性)的灵敏度和特异度分别为53.13和82.19,而阴道镜检查(≥低度发育异常)的灵敏度和特异度分别为56.25和79.09。通过约登指数比较,VILI与阴道镜检查之间无统计学显著差异(P>0.05)。然而,VILI与液基细胞学检测和HPV DNA检测之间存在统计学显著差异(P<0.05)。此外,在现场工作站工作的经验丰富医生与新培训医生之间未发现统计学显著差异(P>0.05)。

结论

VILI使用显微镜时灵敏度较低,但设备成本低,如果增加筛查频率,VILI可成为中国资源匮乏农村地区的主要筛查检测方法之一。

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引用本文的文献

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Single visit approach for management of cervical intraepithelial neoplasia by visual inspection & loop electrosurgical excision procedure.单次就诊通过阴道镜和环形电切术处理宫颈上皮内瘤变。
Indian J Med Res. 2012 May;135(5):614-20.
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BMC Cancer. 2011 Jun 13;11:239. doi: 10.1186/1471-2407-11-239.