Hasanzadeh Malihe, Esmaeili Habibollah, Tabaee Samane, Samadi Fariba
Department of Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
J Obstet Gynaecol Res. 2011 Dec;37(12):1802-6. doi: 10.1111/j.1447-0756.2011.01614.x. Epub 2011 Jul 27.
Alternative methods for cervical cancer screening have been sought. One method, direct visualization with acetic acid (VIA), has proven itself in many clinical trials as an adequate alternative to Pap-smears in developing countries. This study was designed to assess if visual inspection with acetic acid (VIA test) could be an appropriate alternative method for cervical cancer screening. Therefore, we compared VIA, as a stand-alone test, with the gold standard test (colposcopy) in detecting significant cervical pathology in our setting.
The study population consisted of the women who attended the Gynecological Clinic in Ghaem Hospital from April 2008 to April 2009. All of them were tested with VIA. Then, 100 test-positive women and 100 test-negative women were randomly selected and underwent cytology and colposcopy. Cervical biopsies were conducted for the women with abnormal colposcopic findings. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for each test and then were compared.
Sixty-nine women in the VIA-positive group and 61 women in the VIA-negative group had abnormal cytology. After studying the biopsies, 58 women with positive VIA, and two women with negative VIA had a final diagnosis of dysplasia. Positive predictive value for VIA and cytology were 58% and 33%, respectively.
The results of this study indicate that VIA may be a useful and feasible alternative screening test for cervical precancerous and cancerous lesions.
一直在寻找宫颈癌筛查的替代方法。其中一种方法是用醋酸直接可视化检查（VIA），在许多临床试验中已证明其在发展中国家是巴氏涂片的一种合适替代方法。本研究旨在评估醋酸可视化检查（VIA检测）是否可能是一种合适的宫颈癌筛查替代方法。因此，我们将单独使用的VIA检测与金标准检测（阴道镜检查）在我们的研究环境中检测显著宫颈病变的情况进行了比较。
研究人群包括2008年4月至2009年4月在加姆医院妇科门诊就诊的女性。所有女性均接受VIA检测。然后，随机选择100名检测呈阳性的女性和100名检测呈阴性的女性进行细胞学检查和阴道镜检查。对阴道镜检查结果异常的女性进行宫颈活检。计算每种检测的敏感性、特异性、阳性预测值和阴性预测值，然后进行比较。
VIA阳性组中有69名女性和VIA阴性组中有61名女性细胞学检查异常。在研究活检结果后，58名VIA阳性女性和2名VIA阴性女性最终诊断为发育异常。VIA和细胞学检查的阳性预测值分别为58%和33%。
本研究结果表明，VIA可能是一种用于宫颈癌前病变和癌性病变的有用且可行的替代筛查检测方法。
