Screening Group, International Agency for Research on Cancer, Lyon, France.
Int J Gynaecol Obstet. 2010 Oct;111(1):68-72. doi: 10.1016/j.ijgo.2010.04.024. Epub 2010 Jun 8.
A cross-sectional study in Angola to evaluate the feasibility of cervical screening using visual inspection with acetic acid (VIA) or Lugol's iodine (VILI) to detect and treat cervical intraepithelial neoplasia (CIN).
All 8851 women screened by trained nurses received colposcopy and/or colposcopically-directed biopsies. The final disease status was based on histopathology or colposcopy when no or inadequate biopsies were done. The sensitivity, specificity, and predictive values of tests to detect CIN 2-3 were calculated.
VIA was positive in 6.6% and VILI in 32.0% of the women. The positivity rates increased with time only for VILI. CIN 2-3 was diagnosed in 75 women and invasive cancer in 57. The sensitivity and specificity was 70.7% (95% CI, 59.0%-80.6%) and 94.5% (95% CI, 94.0%-95.0%) respectively for VIA, and 88.0% (95% CI, 78.4%-94.4%) and 68.9% (95% CI, 67.9%-69.9%) for VILI. Ninety percent of women detected with CIN received treatment. Treatment was given on the same day as screening to one-third of the 374 women treated with cryotherapy/LEEP. No major complications or adverse effects were associated with treatment.
It was feasible to screen with both visual tests and treat women with CIN in Angola. VILI was less specific than VIA, implying subjectivity in interpreting test results.
在安哥拉进行一项横断面研究，评估使用醋酸视觉检查（VIA）或卢戈氏碘液（VILI）筛查宫颈癌的可行性，以发现和治疗宫颈上皮内瘤变（CIN）。
所有 8851 名经培训护士筛查的妇女均接受阴道镜检查和/或阴道镜指导下活检。最终疾病状态基于组织病理学或阴道镜检查，当未进行或活检不足时。计算了检测 CIN 2-3 的试验的敏感性、特异性和预测值。
VIA 阳性率为 6.6%，VILI 阳性率为 32.0%。只有 VILI 的阳性率随时间增加。75 名妇女诊断为 CIN 2-3，57 名妇女诊断为浸润性癌。VIA 的敏感性和特异性分别为 70.7%（95%CI，59.0%-80.6%）和 94.5%（95%CI，94.0%-95.0%），VILI 分别为 88.0%（95%CI，78.4%-94.4%）和 68.9%（95%CI，67.9%-69.9%）。90%的 CIN 妇女接受了治疗。374 名接受冷冻/LEEP 治疗的妇女中，三分之一在同一天进行了治疗。治疗无重大并发症或不良反应。
在安哥拉，用两种视觉检查方法筛查和治疗 CIN 妇女是可行的。VILI 的特异性低于 VIA，这意味着在解释检测结果时存在主观性。
