【摘要】 目的:评估肉眼醋酸试验(VIA)在宫颈癌前病变筛查中的价值。方法:在2006年9月至2007年12月间在我院宫颈病变专科门诊就诊的妇女中,随机选择383例进行VIA与宫颈液基细胞学(TCT)检查,凡VIA评估为可疑病变或以上和(或)TCT结果为不典型鳞状细胞或以上以及VIA与TCT结果均正常而阴道镜检查有可疑者均作宫颈活检,病理科专家读片和诊断,以病理学诊断作为参照研究。结果:383例中经病理诊断宫颈鳞状上皮内中度瘤变(CIN-2)20例,宫颈鳞状上皮内重度瘤变(CIN-3)71例。VIA筛查出CIN-2及CIN-3的敏感性、特异性、阳性预测值、阴性预测值及Youden指数分别为84.6%、59.9%、42.3%、91.8%及1.45%(以VIA"可疑"或"异常"作为阳性诊断界值);TCT的敏感性、特异性、阳性预测值、阴性预测值及Youden指数范围分别为51.6%～96.7%、60.3%～97.3%、45.8%～87.0%、85.5%～98.1%及1.48%～1.57%(视不同的阳性诊断界值而不同)。结论:经过严格培训的医生进行VIA是宫颈癌前病变筛查中的一项有效可行的方法,可推广应用于医疗资源匮乏地区。更多还原

【Abstract】 Objective To explore visual inspection with acetic acid(VIA) for cervical intraepithelial neoplasia screening.Methods Thinprep cytologic test(TCT) and VIA were performed for 383 women with cervical diseases from Setember 2006 to December 2007 in Guangdong general hospital.Biopsies were taken for women with abnormal reports of VIA and /or TCT.All the women had colposcopic examinations and biopsies were taken when any lesion was found.Results of histopathologic tests were the final diagnoses.Results 20 cervical intraepithelial neoplasia grade 2(CIN-2) and 71 CIN-3 cases were histologically confirmed.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of VIA in detecting CIN-2 and CIN-3 at the suspicious + threshold were 84.6%,59.9%,42.3%,91.8% and 1.45,respectively.And those of TCT were 51.6% ～ 96.7%,60.3% ～ 97.3%,45.8% ～ 87.0%,85.5% ～ 98.1% and 1.48% ～ 1.57%,respectively depending on the abnormal threshold used for defining positive results.Conclusion VIA performed by physicians with standardized training may be a feasible way in cervical intraepithelial neoplasia screening,which can offer clinical prospect in low-resource settings.更多还原