子宫颈造影术在子宫颈癌前病变检测中是否有作用？
Is there a role for cervicography in the detection of premalignant lesions of the cervix uteri?
作者信息
Coibion M, Autier P, Vandam P, Delobelle A, Huet F, Hertens D, Vosse M, Andry M, De Sutter P, Heimann R
机构信息
Jules Bordet Institute, Brussels, Belgium.
出版信息
Br J Cancer. 1994 Jul;70(1):125-8. doi: 10.1038/bjc.1994.260.
The characteristics of cervicography and the Papanicolaou smear test have been compared for the detection of cervix lesions classified as CIN I or more. A total of 4,015 women were entered into the study. The sensitivity of cervicography is significantly higher (McNemar test, P < 0.0001), but its specificity remains significantly lower (McNemar test, P < 0.0001), and its higher sensitivity does not apply to lesions classified as CIN II or more (high-grade lesions). Hence, if patients with a positive screen result are to be referred for colposcopy-biopsy, cervicography is not a suitable alternative to the smear test for the screening of cervical cancer. However, cervicography can be envisaged as a complementary tool to the smear test because of (a) its higher capability to detect high-grade lesions among women less than 35 years old and (b) its potential superiority in following low-grade lesions. It may also serve as a tool for quality assurance audit of the smear test.
为了检测分类为CIN I或更高等级的宫颈病变，对宫颈造影和巴氏涂片检查的特征进行了比较。共有4015名女性参与了这项研究。宫颈造影的敏感性显著更高（McNemar检验，P<0.0001），但其特异性仍然显著更低（McNemar检验，P<0.0001），并且其较高的敏感性不适用于分类为CIN II或更高等级的病变（高级别病变）。因此，如果筛查结果呈阳性的患者要被转诊进行阴道镜活检，对于宫颈癌筛查而言，宫颈造影并非巴氏涂片检查的合适替代方法。然而，宫颈造影可被视为巴氏涂片检查的一种补充工具，原因在于：（a）其在检测35岁以下女性高级别病变方面能力更强；（b）其在追踪低级别病变方面可能具有优势。它还可作为巴氏涂片检查质量保证审核的一种工具。
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