Milla Villeda R H, Alvarado Zaldívar G, Sánchez Anguiano L F, Barrera Tovar M, Vázquez Arreola I
Clínica de Colposcopía Privada, Durango, Dgo.
Ginecol Obstet Mex. 1997 Jun;65:235-8.
The objective of this report was to assess the sensitivity and specificity of Pap smear and to evaluate if routine colposcopy can improve cervical screening. One hundred and fifty patients undergoing routine cervical cytologic screening in our outpatient clinic were randomly selected. All patients were evaluated by colposcopy and cervical punch biopsy. Pap smears and biopsies specimens were interpreted independently. Colposcopy was performed and interpreted without knowledge of cytologic or histologic findings. The statistical analysis was carried out with a chi square (chi 2) test. A P value of less than 0.05 was considered significant. Twenty three patients (15.3%) who had biopsy proved to have cervical pathology. Pap smear identified only 4/23 (17%) of these patients. Colposcopy noted atypical transformation zones in 20/23 (97%), P < 0.001). Fifteen of 27 patients (55.5%) with negative Pap smears had colposcopic anormalities and histologically proved cervical intraepithelial neoplasia (CIN). We concluded that it is necessary to improve sensitivity and that colposcopy may enhance cervical screening particularly in women with otherwise negative Papapnicolaou smears.
本报告的目的是评估巴氏涂片的敏感性和特异性，并评估常规阴道镜检查是否能改善宫颈癌筛查。我们在门诊随机选择了150例接受常规宫颈细胞学筛查的患者。所有患者均接受了阴道镜检查和宫颈活检。巴氏涂片和活检标本由独立人员解读。阴道镜检查的实施和解读过程中不了解细胞学或组织学检查结果。采用卡方（χ2）检验进行统计分析。P值小于0.05被认为具有统计学意义。23例（15.3%）活检证实有宫颈病变的患者中，巴氏涂片仅识别出其中的4/23（17%）。阴道镜检查发现20/23（97%）的患者有非典型转化区（P<0.001）。27例巴氏涂片阴性的患者中有15例（55.5%）存在阴道镜异常，并经组织学证实为宫颈上皮内瘤变（CIN）。我们得出结论，有必要提高敏感性，阴道镜检查可能会增强宫颈癌筛查，特别是对于巴氏涂片结果为阴性的女性。
