Tawa K, Forsythe A, Cove J K, Saltz A, Peters H W, Watring W G
Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Los Angeles, California.
Obstet Gynecol. 1988 Feb;71(2):229-35.
A total of 3271 gynecology patients between the ages of 18-50 years were screened for cervical intraepithelial neoplasia and invasive cervical cancer by simultaneous Papanicolaou smears and cervigram, a noninvasive photographic method recently introduced for screening. The accuracy of each screening test, when positive or suspicious, was evaluated independently and the results compared with colposcopically directed biopsy results. The cervigram was significantly more sensitive than the Papanicolaou smear (P less than .001), whereas the Papanicolaou smear was significantly more specific than the cervigram in detecting cervical intraepithelial neoplasia (P less than .001). Cost analysis integrating sensitivity and specificity with cost per procedure indicated a greater yield of cervical intraepithelial neoplasia with the cervigram than with the Papanicolaou smear, by 3.7:1 case per dollar.
通过同时进行巴氏涂片和宫颈造影（一种最近引入用于筛查的非侵入性摄影方法），对3271名年龄在18至50岁之间的妇科患者进行了宫颈上皮内瘤变和浸润性宫颈癌筛查。当每项筛查试验呈阳性或可疑时，独立评估其准确性，并将结果与阴道镜引导下活检结果进行比较。宫颈造影比巴氏涂片显著更敏感（P<0.001），而在检测宫颈上皮内瘤变方面，巴氏涂片比宫颈造影显著更具特异性（P<0.001）。将敏感性和特异性与每次检查成本相结合的成本分析表明，宫颈造影检测宫颈上皮内瘤变的产出比巴氏涂片更高，每花费一美元，前者发现病例数与后者的比例为3.7:1。
