论文部分内容阅读
目的评价基层医生采用醋酸/碘染色后肉眼观察法(VIA/VILI)在农村地区筛查子宫颈癌及癌前病变的效果。方法采用醋酸染色法(acetic acid,VIA)和碘染色法(lugol’s iodine,VILI)对重庆市涪陵区30~59岁的的已婚妇女进行人群为基础的子宫颈癌筛查,VIA或VILI阳性者行阴道镜检查,在异常病变处取活检并进行病理组织诊断;通过连续2年筛查的结果,评价该筛查方案的效果。结果 2006-2010年对10 279人连续筛查2次,VIA/VILI阳性率14.50%,阳性者中1 487人行阴道镜检查,阴道镜转诊率14.47%,32.28%在病变处取活检;首次病理确诊61例子宫颈上皮内瘤变(intraepithelial neoplasia,CIN)Ⅰ、15例CINⅡ、25例CINⅢ、2例早浸/浸润性子宫颈癌,第2轮筛查病理确诊26例CINⅠ、11例CINⅡ、3例CINⅢ、0例早浸/浸润性子宫颈癌;经2轮筛查后CINⅠ、CINⅡ、CINⅢ、早浸/浸润性宫颈癌的检出率分别为0.85%、0.25%、0.27%、0.02%。结论经济欠发达的农村地区,由经过培训的基层医生采用肉眼观察,以阴道镜检查作为技术保障,对30~59岁妇女进行子宫颈癌及癌前病变的筛查是可行的。
Objective To evaluate the effect of VIA / VILI on screening of cervical cancer and precancerous lesions in rural areas by primary physicians using acetate / iodine staining. Methods Married women aged 30-59 years old in Fuling District of Chongqing City were screened for cervical cancer based on acetic acid (VIA) and iodine staining (VILI). VIA or VILI was positive Colposcopy examination, biopsy in abnormal lesions and pathological diagnosis; through two consecutive years of screening results, evaluate the effectiveness of the screening program. Results A total of 10 279 patients were screened twice a day for 10 279 patients from 2006 to 2010. The positive rate of VIA / VILI was 14.50%. Among the 487 positive patients, colposcopy was colposcopy. The colposcopy referral rate was 14.47% and 32.28% Twenty-one cases were diagnosed as intraepithelial neoplasia (CIN) Ⅰ, 15 cases of CINⅡ, 25 cases of CINⅢ, and 2 cases of early impregnated / invasive cervical cancer. The pathologic diagnosis of 26 cases of CINⅠ, 11 cases of CINⅡ, 3 cases of CIN Ⅲ, 0 cases of early immersion / invasive cervical cancer. The detection rates of CINⅠ, CINⅡ, CINⅢ, early impregnation / invasive cervical cancer after two rounds of screening were 0.85%, 0.25%, 0.27% and 0.02% . Conclusions In economically underdeveloped rural areas, it is feasible for the screening of cervical cancer and precancerous lesions in women aged 30-59 years by the trained primary doctors with the naked eye and the colposcopy as a technical safeguard.