Khan Momna, Sultana Syeda Seema, Jabeen Nigar, Arain Uzma, Khans Salma
J Pak Med Assoc. 2015 Feb;65(2):192-5.
To determine the diagnostic accuracy of visual inspection of cervix using 3% acetic acid as a screening test for early detection of cervical cancer taking histopathology as the gold standard.
The cross-sectional study was conducted at Civil Hospital Karachi from July 1 to December 31, 2012 and comprised all sexually active women aged 19-60 years. During speculum examination 3% acetic acid was applied over the cervix with the help of cotton swab. The observations were noted as positive or negative on visual inspection of the cervix after acetic acid application according to acetowhite changes. Colposcopy-guided cervical biopsy was done in patients with positive or abnormal looking cervix. Colposcopic-directed biopsy was taken as the gold standard to assess visual inspection readings. SPSS 17 was used for statistical analysis.
There were 500 subjects with a mean age of 35.74 ± 9.64 years. Sensitivity, specifically, positive predicted value, negative predicted value of visual inspection of the cervix after acetic acid application was 93.5%, 95.8%, 76.3%, 99%, and the diagnostic accuracy was 95.6%.
Visual inspection of the cervix after acetic acid application is an effective method of detecting pre-invasive phase of cervical cancer and a good alternative to cytological screening for cervical cancer in resource-poor setting like Pakistan and can reduce maternal morbidity and mortality.
以组织病理学为金标准,确定使用3%醋酸对宫颈进行视诊作为宫颈癌早期检测筛查试验的诊断准确性。
于2012年7月1日至12月31日在卡拉奇市民医院开展横断面研究,纳入所有年龄在19至60岁之间的性活跃女性。在阴道镜检查期间,借助棉签将3%醋酸涂抹于宫颈。根据醋酸白变化,在涂抹醋酸后对宫颈进行视诊,观察结果记录为阳性或阴性。对宫颈视诊阳性或外观异常的患者进行阴道镜引导下的宫颈活检。以阴道镜引导下的活检作为评估视诊结果的金标准。使用SPSS 17进行统计分析。
共有500名受试者,平均年龄为35.74±9.64岁。具体而言,涂抹醋酸后宫颈视诊的敏感性、阳性预测值、阴性预测值分别为93.5%、95.8%、76.3%、99%,诊断准确性为95.6%。
涂抹醋酸后对宫颈进行视诊是检测宫颈癌浸润前期的有效方法,在巴基斯坦等资源匮乏地区是宫颈癌细胞学筛查的良好替代方法,可降低孕产妇发病率和死亡率。