Ferris D G, Payne P, Frisch L E, Milner F H, diPaola F M, Petry L J
Department of Family Medicine, Medical College of Georgia, Augusta 30912-3500.
J Fam Pract. 1993 Aug;37(2):158-64.
Cervicography is an adjunct method of cervical cancer screening intended to complement cervical cytologic sampling, ie, Papanicolaou (Pap) smear. Cervicography involves obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the screening use of cervicography as an adjunct to clinical cytologic screening.
Women presenting at four clinical sites for annual cervical cytologic screening or for follow-up evaluation after receiving an abnormal Pap smear result were enrolled in the study. Each patient received a Pap smear and a cervigram. Those women in whom abnormalities were detected by either test subsequently underwent colposcopy, and when appropriate, histologic specimens were obtained.
Pap smear and cervigram data were obtained for 1449 women. When premalignant or malignant histologic test results were considered as a true positive, the Pap smear correctly identified 25.6% of subjects with dysplasia and 37.5% with severe dysplasia. The Pap smear failed to identify the one patient with invasive cancer. The cervigram detected 50.5% of the subjects with dysplasia and 77.8% of the subjects with severe dysplasia, and it identified the one patient with invasive cancer when a positive cervigram was considered a true positive. When the results were combined, the two tests identified 62.9% of subjects with histologically confirmed dysplasia, 81.3% of subjects with severe dysplasia, and 100% (one patient) with cancer.
The cervigram detected twice the number of patients with premalignant disease as the Pap smear alone, and correctly identified the invasive cancer. Cervicography improved the detection of cervical disease.
宫颈摄影术是一种宫颈癌筛查的辅助方法，旨在补充宫颈细胞学采样，即巴氏涂片检查。宫颈摄影术包括获取并评估宫颈的照片图像。本研究的目的是评估宫颈摄影术作为临床细胞学筛查辅助手段的筛查效用。
在四个临床地点进行年度宫颈细胞学筛查或在巴氏涂片结果异常后进行随访评估的女性被纳入研究。每位患者均接受了巴氏涂片检查和宫颈摄影检查。随后，对两种检查中检测出异常的女性进行阴道镜检查，并在适当情况下获取组织学标本。
共获得了1449名女性的巴氏涂片检查和宫颈摄影检查数据。当将癌前或恶性组织学检查结果视为真阳性时，巴氏涂片检查正确识别出25.6%的发育异常患者和37.5%的重度发育异常患者。巴氏涂片检查未能识别出那名浸润癌患者。宫颈摄影检查检测出50.5%的发育异常患者和77.8%的重度发育异常患者，并且在将阳性宫颈摄影检查结果视为真阳性时识别出了那名浸润癌患者。当将两种检查结果合并时，两种检查共同识别出62.9%经组织学确诊的发育异常患者、81.3%的重度发育异常患者以及100%（一名患者）的癌症患者。
宫颈摄影检查检测出的癌前疾病患者数量是单独巴氏涂片检查的两倍，并且正确识别出了浸润癌。宫颈摄影术提高了宫颈疾病的检出率。
