比较巴氏涂片检查和5%醋酸直接目视检查（DVI）在宫颈癌筛查中的结果。

Comparing the results of Pap smear and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening.

作者信息

Pourasad-Shahrak Shakiba, Salehi-Pourmehr Hanieh, Mostafa-Garebaghi Parvin, Asghari-Jafarabadi Mohammad, Malakouti Jamileh, Haghsay Monireh

机构信息

Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran.

Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Niger Med J. 2015 Jan-Feb;56(1):35-8. doi: 10.4103/0300-1652.149168.

DOI:10.4103/0300-1652.149168

PMID:25657491

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4314857/

Abstract

BACKGROUND

Cervical cancer is the most second common cancer among Iranian women. This study was carried out to compare the results of Pap smear method and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening in Tabriz, Iran.

MATERIAL AND METHODS

This cross-sectional study was carried out in Alzahra Therapeutic-Educational Centre, Tabriz, Iran in 2013 on 1000 women. First, Pap smear was done for all women, and then the cervix exposed with 5% acetic acid by cotton swab for 30 seconds and observed under adequate light. At the end, women with abnormal results in Pap smear or DVI method were referred to colposcopy and biopsy. Test's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), LR+, LR- and confidence interval (CI) were determined (P < 0.05).

RESULTS

Nine-hundred and seventy-four (94.7%) cases were normal and had no abnormal findings and 26 (2.6%) participants had positive results in Pap smear or DVI test. Twelve women had abnormal Pap smear (nine women with atypical squamous cells of undetermined significance, ASCUS, three women with dysplasia, atypical endocervical, and low-grade squamous intraepithelial lesion, LSIL results) and 14 women had positive DVI (four women with human papillomavirus, HPV or koilocyte,) and one women with abnormality in both method had carcinoma in biopsy that referred to oncologist. In this study the sensitivity, specificity, PPV and NPV for DVI were 71.4%, 50%, 35.7%, and 81.8% respectively in comparison with 14.3%, 50%, 10%, and 60% for Pap smear.

CONCLUSION

As the DVI method has higher sensitivity and positive predictive value than Pap smear, it could be used as a useful method beside the Pap smear.

摘要

背景

宫颈癌是伊朗女性中第二常见的癌症。本研究旨在比较巴氏涂片法和5%醋酸直接目视检查（DVI）在伊朗大不里士宫颈癌筛查中的结果。

材料与方法

2013年在伊朗大不里士的阿尔扎赫拉治疗教育中心对1000名女性进行了这项横断面研究。首先，对所有女性进行巴氏涂片检查，然后用棉签蘸5%醋酸暴露宫颈30秒，并在充足光线下观察。最后，巴氏涂片或DVI方法结果异常的女性被转诊进行阴道镜检查和活检。确定了试验的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、LR+、LR-和置信区间（CI）（P<0.05）。

结果

974例（94.7%）病例正常，无异常发现，26例（2.6%）参与者巴氏涂片或DVI检测结果为阳性。12名女性巴氏涂片异常（9名意义不明确的非典型鳞状细胞，ASCUS，3名发育异常、非典型宫颈内膜和低级别鳞状上皮内病变，LSIL结果的女性），14名女性DVI阳性（4名人类乳头瘤病毒，HPV或挖空细胞阳性的女性），两种方法均异常的1名女性活检为癌，转诊给肿瘤学家。在本研究中，DVI的敏感性、特异性、PPV和NPV分别为71.4%、50%、35.7%和81.8%，而巴氏涂片的相应结果分别为14.3%、50%、10%和60%。