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目的评价多种宫颈癌筛查方式,为农村欠发达地区优选一种较适宜的筛查方法。方法在宫颈癌高发区山西省阳城县对744名年龄为20￣59岁已婚妇女,进行宫颈癌危险因素的流行病学问卷调查、阴道醋酸染色(VIA)、碘染色(VILI)及阴道镜检查并进行13种高危型HPVDNA的检测、收集阴道脱落细胞进行液基细胞学诊断,宫颈有病变者取可疑组织病检。数据用FoxPro6.0录入和整理后,运用SAS软件进行统计学处理和分析。结果CINI以上病例73人,普查人群检出率9.81%(73/744),其中CINⅠ41例,CINⅡ18例,CINⅢ13例,腺癌1例。HPV人群感染率15.99%(119/744)。以病理组织学为金标准(≥CINⅡ为阳性),各检查方法灵敏度和特异度分别为VIA(10.53,82.44),VILI(53.13,82.44),阴道镜检查(56.25,79.35)、液基细胞学(68.75,97.29)和HPV(93.75,87.50)。结论从经济性、适用性综合考虑,VILI在农村不发达地区是一种可行的筛查手段。
Objective To evaluate a variety of cervical cancer screening methods for the less developed areas in rural areas preferred a more appropriate screening method. Methods A total of 744 married women aged from 20 to 59 were enrolled in the epidemiological survey of risk factors for cervical cancer in Yangcheng County, Shanxi Province, China. Vaginal acetic acid staining (VIA), iodine staining (VILI) and vaginal Microscopic examination and detection of 13 kinds of high-risk HPVDNA collected vaginal exfoliated cells for liquid-based cytological diagnosis of cervical lesions were suspicious tissue disease examination. After entering and finishing the data with FoxPro6.0, using SAS software for statistical analysis and analysis. Results CINI more than 73 cases, the census crowd detection rate of 9.81% (73/744), of which CIN Ⅰ in 41 cases, CIN Ⅱ in 18 cases, CIN Ⅲ in 13 cases, adenocarcinoma in 1 case. HPV infection rate of 15.99% (119/744). The pathological histology of the gold standard (≥ CIN Ⅱ positive), the sensitivity and specificity of each test were VIA (10.53,82.44), VILI (53.13,82.44), colposcopy (56.25,79.35), liquid-based cytology (68.75, 97.29) and HPV (93.75, 87.50). Conclusion From the perspective of economy and applicability, VILI is a feasible screening method in underdeveloped rural areas.