子宫颈造影术。它能改善宫颈癌筛查吗？

Cervicography. Does it improve cervical cancer screening?

作者信息

Baldauf J J, Dreyfus M, Ritter J, Meyer P, Philippe E

机构信息

Department of Obstetrics and Gynecology 1, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, France.

出版信息

Acta Cytol. 1997 Mar-Apr;41(2):295-301. doi: 10.1159/000332515.

DOI:10.1159/000332515

PMID:9100757

Abstract

OBJECTIVE

To compare the reliability of cytology with that of cervicography and with the use of both tests when screening for neoplasia of the cervix and to analyze the causes of false positive and false negative results with both methods.

STUDY DESIGN

The results of cytology and cervicography in 1,709 patients (1,447 seen for routine screening, 82 for follow-up after treatment for cervical neoplasia and 180 referred because of cytologic anomalies) were correlated with colpohistologic findings.

RESULTS

Cervicography entailed more defective examinations than did cytology (8.9% vs. 0.2%, P < .0001). It was less sensitive (51% vs. 59%, P = .320) and less specific (96% vs. 98%, P = .004). Whatever the clinical criteria (patient's age, parity, pregnancy or history of cervical treatment), the rate of false positives with cervicography was always higher than with cytology, as was the rate of false negatives, except in pregnant women.

CONCLUSION

Cervicography does not seem to offer a worthwhile alternative to cytology for cervical screening.

摘要

目的

比较细胞学检查与宫颈造影检查以及两种检查联合使用时在宫颈癌前病变筛查中的可靠性，并分析两种方法出现假阳性和假阴性结果的原因。

研究设计

对1709例患者（1447例行常规筛查，82例因宫颈肿瘤治疗后进行随访，180例因细胞学异常转诊）的细胞学检查和宫颈造影检查结果与阴道镜组织学检查结果进行相关性分析。

结果

宫颈造影检查出现缺陷检查的比例高于细胞学检查（8.9%对0.2%，P < 0.0001）。其敏感性较低（51%对59%，P = 0.320），特异性也较低（96%对98%，P = 0.004）。无论临床标准如何（患者年龄、产次、妊娠情况或宫颈治疗史），宫颈造影检查的假阳性率始终高于细胞学检查，假阴性率也是如此，不过孕妇除外。