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[目的]通过对9176名妇女采用醋酸或碘染色肉眼筛查方法(VIA/VILI)筛查宫颈癌的早诊早治结果分析,评价在农村高发区宫颈癌采用该筛查方式推广应用的可行性。[方法]以山西省襄垣县30~59岁的妇女作为研究对象进行以自然人群为基础的宫颈癌筛查,用醋酸染色后肉眼观察(VIA)和碘染色后肉眼观察(VILI)进行宫颈检查,VIA或VILI阳性者进行阴道镜检查,阴道镜异常者在病变处取活检进行病理学诊断。采用同样方法对该人群连续复查两年。[结果]首次筛查人群参与率为73.92%,二次复查率为84.3%。2005年首次筛查了1287例妇女,最终经病理确诊的CINⅠ10例、CINⅡ9例、CINⅢ13例、宫颈癌3例。该方法与已往该地区采用液基细胞学和HPV检测联合筛查方法相比较,CINⅡ和≥CINⅢ病变的检出率略低,但差异无统计学意义。连续两年复查出5例CINⅠ,3例CINⅡ,1例CINⅢ。2006~2008年共筛查7889例,首次筛查最终病理确诊116例CINⅠ,36例CINⅡ,35例CINⅢ,4例早期浸润癌,浸润性鳞癌5例。第二次复查,经病理确诊75例CINⅠ,24例CINⅡ,15例CINⅢ,1例早期浸润癌。[结论]在资源有限,经济不发达的农村地区,用VIA/VILI方法对宫颈癌及其癌前病变的筛查是可行的,建议进一步在农村地区进行推广。
[Objective] To evaluate the early diagnosis and treatment of cervical cancer in 9176 women by using VIA / VILI (VIA / VILI), and to evaluate the feasibility of using this screening method to promote cervical cancer in rural high incidence area Sex. [Methods] A natural population-based screening of cervical cancer was performed in women aged 30-59 years in Xiangyuan County, Shanxi Province. Vital signs (VIA) after acetic acid staining and VILI after iodine staining were used for cervical screening , VIA or VILI positive colposcopy, colposcopy abnormalities in the lesion biopsy for pathological diagnosis. The same method of continuous review of the crowd for two years. [Results] The first screening rate was 73.92% and the second screening rate was 84.3%. In 2005, 1287 women were screened for the first time. In the end, 10 cases were confirmed by pathology, including 9 cases of CIN, 13 cases of CIN, 13 cases of CIN and 3 cases of cervical cancer. Compared with the combined screening method of liquid-based cytology and HPV in the past, the detection rate of CINⅡ and ≥CINⅢ lesions was slightly lower, but the difference was not statistically significant. Five cases of CIN Ⅰ, 3 cases of CIN Ⅱ and 1 case of CIN Ⅲ were reviewed in two consecutive years. From 2006 to 2008, a total of 7889 cases were screened. Among them, 116 cases of CINⅠ, 36 cases of CINⅡ, 35 cases of CINⅢ, 4 cases of early invasive carcinoma and 5 cases of invasive squamous cell carcinoma were screened for the first time. The second review, pathologically confirmed 75 cases of CIN Ⅰ, 24 cases of CIN Ⅱ, 15 cases of CIN Ⅲ, 1 case of early invasive carcinoma. [Conclusion] The screening of cervical cancer and its precancerous lesions by VIA / VILI method is feasible in rural areas with limited resources and underdeveloped economy. It is suggested to further promote it in rural areas.