尼日利亚贝宁城醋酸目视宫颈检查和阴道镜检查诊断性能的评估

Evaluation of diagnostic performances of visual cervical inspection with acetic acid and colposcopy in Benin city, Nigeria.

作者信息

Olagbuji B N, Okonkwo C A, Akhiwu W

机构信息

Department of Obstetrics & Gynaecology,University of Benin Teaching Hospital, PMB 10108, Benin- City, Edo State.

出版信息

West Afr J Med. 2014 Jan-Mar;33(1):26-31.

PMID:24872263

Abstract

OBJECTIVE

To determine the performance indicators of visual inspection with acetic acid (VIA) and colposcopy to detect cervical premalignant lesions.

METHODS

A prospective cross-sectional study evaluating performance indicators of visual cervical inspection with acetic acid and colposcopy using directed biopsy for histopathology as the reference standard in a Colposcopy unit at a referral tertiary hospital in Nigeria. Consecutive sample of 212 apparently healthy, ambulant, asymptomatic women with an intact uterus and with no past history of cervical neoplasia were recruited.

RESULTS

A total of 195 women had VIA and satisfactory colposcopy with directed biopsy. Overall test positivity was 29.7% for VIA, 36.9% for colposcopy and 32.8% for histology of colposcopically directed biopsy. Using CIN 2 as the disease threshold; the sensitivity, specificity, positive predictive value and negative predictive value of VIA were 70.8%, 67.0%, 29.3% & 94.9% while those of colposcopy were 87.5%, 97.7%, 84.0% &98.2%,respectively.

CONCLUSION

Although the test characteristics of both VIA and colposcopy appear satisfactory in this study, the data suggests that colposcopy performs better than VIA in the diagnosis of cervical neoplasia. However, in view of its ease of administration and low logistic requirements, VIA still has a vital role to play in population-based screening in our environment.

摘要

目的

确定醋酸目视检查（VIA）和阴道镜检查检测宫颈癌前病变的性能指标。

方法

一项前瞻性横断面研究，在尼日利亚一家转诊三级医院的阴道镜检查科室，以组织病理学直接活检为参考标准，评估醋酸宫颈目视检查和阴道镜检查的性能指标。连续招募了212名明显健康、能走动、无症状、子宫完整且无宫颈肿瘤病史的女性。

结果

共有195名女性接受了VIA和满意的阴道镜检查及直接活检。VIA的总体检测阳性率为29.7%，阴道镜检查为36.9%，阴道镜引导活检的组织学检查为32.8%。以CIN 2作为疾病阈值；VIA的敏感性、特异性、阳性预测值和阴性预测值分别为70.8%、67.0%、29.3%和94.9%，而阴道镜检查的相应指标分别为87.5%、97.7%、84.0%和98.2%。