哥伦比亚的肉眼观察宫颈癌筛查。

Cervical cancer screening with naked-eye visual inspection in Colombia.

机构信息

Subdireccion Investigaciones y Salud Pública, Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia.

出版信息

Int J Gynaecol Obstet. 2010 Jun;109(3):230-4. doi: 10.1016/j.ijgo.2010.01.019. Epub 2010 Mar 29.

DOI:10.1016/j.ijgo.2010.01.019

PMID:20347442

Abstract

OBJECTIVE

To assess the accuracy of visual inspection provided by nurses through combining acetic acid (VIA) and Lugol's iodine (VILI) in a low-resource region of Colombia.

METHODS

A cross-sectional study with 4957 women was conducted to evaluate visual inspection techniques as the basis for see-and-treat approaches in cervical cancer control. All women underwent conventional cytology, VIA performed by nurses, and a combination of VIA and VILI. All women underwent colposcopy and biopsies were obtained for any positive test.

RESULTS

A total of 762 women underwent biopsy, 4945 women were included in the analysis of conventional cytology, and 4957 were included in the analysis of VIA and VIA-VILI. Positivity rates were 1.3% and 4.3% for HSIL and LSIL cytology, 7.4% for VIA, and 10.1% for VIA-VILI. Sensitivity for cytology was 52.9% and 36.8% for LSIL and HSIL thresholds, 53.6% for VIA, and 68.1% for VIA-VILI. The corresponding specificity was 95.0%, 99.2%, 93.2%, and 90.8% respectively. The parallel combination of VIA-VILI and cytology LSIL-threshold revealed the best performance as a screening strategy.

CONCLUSION

The use of VIA-VILI simulating colposcopic procedures and provided by nurses represents a good alternative for implementing see-and-treat programs in Latin America. Program constraints should be taken into account.

摘要

目的

评估在哥伦比亚资源匮乏地区护士通过联合醋酸（VIA）和卢戈氏碘液（VILI）进行目视检查的准确性。

方法

进行了一项横断面研究，纳入了 4957 名女性，以评估目视检查技术作为宫颈癌控制中见即治方法的基础。所有女性均接受常规细胞学检查、护士进行的 VIA 检查以及 VIA 和 VILI 的联合检查。所有女性均接受阴道镜检查，并对任何阳性检查结果进行活检。

结果

共有 762 名女性接受了活检，4945 名女性纳入常规细胞学分析，4957 名女性纳入 VIA 和 VIA-VILI 分析。HSIL 和 LSIL 细胞学的阳性率分别为 1.3%和 4.3%，VIA 为 7.4%，VIA-VILI 为 10.1%。细胞学的敏感性分别为 LSIL 和 HSIL 阈值的 52.9%和 36.8%，VIA 为 53.6%，VIA-VILI 为 68.1%。相应的特异性分别为 95.0%、99.2%、93.2%和 90.8%。VIA-VILI 和细胞学 LSIL 阈值的平行联合作为筛查策略表现最佳。