便携式掌上阴道镜检查与使用醋酸和卢戈氏碘作为对比介质的临床标准阴道镜检查相比具有可比性：秘鲁的一项研究。
Portable Pocket colposcopy performs comparably to standard-of-care clinical colposcopy using acetic acid and Lugol's iodine as contrast mediators: an investigational study in Peru.
机构信息
Department of Biomedical Engineering, Duke University, Durham, NC, USA.
Duke Global Health Institute, Duke University, Durham, NC, USA.
出版信息
BJOG. 2018 Sep;125(10):1321-1329. doi: 10.1111/1471-0528.15326. Epub 2018 Jul 18.
OBJECTIVE
Our goal was to develop a tele-colposcopy platform for primary-care clinics to improve screening sensitivity and access. Specifically, we developed a low-cost, portable Pocket colposcope and evaluated its performance in a tertiary healthcare centre in Peru.
DESIGN AND SETTING
Images of the cervix were captured with a standard-of-care and Pocket colposcope at la Liga Contra el Cáncer in Lima, Peru.
POPULATION
Two hundred Peruvian women with abnormal cytology and/or human papillomavirus positivity were enrolled.
METHODS
Images were collected using acetic acid and Lugol's iodine as contrast agents. Biopsies were taken as per standard-of-care procedures.
MAIN OUTCOME MEASURES
After passing quality review, images from 129 women were sent to four physicians who provided a diagnosis for each image.
RESULTS
Physician interpretation of images from the two colposcopes agreed 83.1% of the time. The average sensitivity and specificity of physician interpretation compared with pathology was similar for the Pocket (sensitivity = 71.2%, specificity = 57.5%) and standard-of-care (sensitivity = 79.8%, specificity = 56.6%) colposcopes. When compared with a previous study where only acetic acid was applied to the cervix, results indicated that adding Lugol's iodine as a secondary contrast agent improved the percent agreement between colposcopes for all pathological categories by up to 8.9% and the sensitivity and specificity of physician interpretation compared with pathology by over 6.0 and 9.0%, respectively.
CONCLUSIONS
The Pocket colposcope performance was similar to that of a standard-of-care colposcope when used to identify precancerous and cancerous lesions using acetic acid and Lugol's iodine during colposcopy examinations in Peru.
TWEETABLE ABSTRACT
The Pocket colposcope performance was similar to that of a standard-of-care colposcope when identifying cervical lesions.
目的
我们旨在开发一种远程阴道镜平台，以提高初级保健诊所的筛查敏感性和可及性。具体而言，我们开发了一种低成本、便携式的 Pocket 阴道镜，并在秘鲁的一家三级保健中心对其性能进行了评估。
设计和设置
在秘鲁利马的 la Liga Contra el Cáncer，使用标准护理和 Pocket 阴道镜拍摄宫颈图像。
人群
共有 200 名患有细胞学异常和/或人乳头瘤病毒阳性的秘鲁女性入组。
方法
使用醋酸和卢戈氏碘作为对比剂采集图像。根据标准护理程序进行活检。
主要观察指标
通过质量审查后，将 129 名女性的图像发送给四位医生，每位医生为每张图像提供诊断。
结果
两位医生对两种阴道镜图像的解释有 83.1%的时间是一致的。与病理结果相比，Pocket（敏感性=71.2%，特异性=57.5%）和标准护理（敏感性=79.8%，特异性=56.6%）阴道镜的医生解释的平均敏感性和特异性相似。与仅在宫颈上应用醋酸的先前研究相比，结果表明，添加卢戈氏碘作为二级对比剂，可使所有病理类别中阴道镜之间的百分比一致性提高 8.9%，并使医生解释与病理相比的敏感性和特异性分别提高 6.0%和 9.0%。
结论
在秘鲁，使用 Pocket 阴道镜和醋酸、卢戈氏碘联合进行阴道镜检查时，Pocket 阴道镜的性能与标准护理阴道镜相似，可用于识别癌前病变和癌症病变。
推特摘要
在识别宫颈病变时，Pocket 阴道镜的性能与标准护理阴道镜相似。
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