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中国癌症防治杂志

中国癌症防治杂志

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醋酸肉眼观察在农村宫颈癌筛查中的应用

崔艳萍;肖淑君;余文洁;钟小烨;莫潘艳;   

  1. 广东省清远市妇幼保健院;
  • 收稿日期:2010-03-25 修回日期:2010-03-25 出版日期:2010-03-25 发布日期:2010-03-25

Application of visual inspection with acetic acid staining for cervical cancer screening in rural area

CUI Yan-ping,XIAO Shu-jun,YU Wen-jie,et al.   

  1. (Maternal and Child Health Hospital of Qingyuan,Guangdong 511515,China
  • Received:2010-03-25 Revised:2010-03-25 Online:2010-03-25 Published:2010-03-25

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被引次数

7

摘要： 目的探讨醋酸肉眼观察在农村宫颈癌筛查中的应用价值。方法对中央转移支付项目宫颈癌筛查早诊早治在广东省清远市2008年与2009年两年目标人群宫颈癌筛查的结果进行回顾性分析。两年均应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,结果异常者进行阴道镜下活检并得到最终的病理学诊断,2009年同时对2008年的目标人群进行复查,同时将该次筛查不同级别病变的检出率与我院妇科宫颈癌筛查结果进行比较。根据病理结果,对病理结果正常及CINⅠ级者为下一年进行复查,CINⅡ级以上者进行治疗。结果2008年与2009年筛查人群的顺应性分别为38.38%、50.71%,最终经活检病理确诊分别为正常宫颈52例(86.67%)、51例(70.83);CINⅠ5例(8.33%)、11例(15.28%);CINⅡ1例(1.67%)、4例(5.56%);CINⅢ2例(3.33%)、5例(6.94%);宫颈癌0例(0.00%)、1例(1.39%);治疗率分别为33.33%、30.00%。2009年对2008年筛查人群进行复查,复查率12.06%,最终经活检病理确诊分别为正常宫颈2例(33.33%);CINⅠ3例(50.00%);CINⅡ1例(16.67%);CINⅢ0例(0.00%)。2008年筛查结果与我院妇科普查宫颈癌筛查结果进行比较差异无统计学意义(P>0.05),但2009年筛查结果与我院宫颈癌筛查结果进行比较差异有统计学意义(P<0.05)。结论在资源有限、经济不发达的农村地区,肉眼观察是一种经济、有效的筛查方法,建议在农村地区进行推广。同时,做好宫颈癌知识宣教,提高参与率及治疗率,真正达到宫颈癌早诊早治,以降低宫颈癌发病率及死亡率的目的。

关键词: 子宫颈癌, 肉眼观察, 筛查方法, 农村

Abstract: Objective To investigate the feasibility of visual inspection with acetic acid staining for cervical cancer screening in rural area.Methods Retrospective analysis was performed on the data of cervical cancer screening collected from 2008 to 2009 in Qingyuan city of Guangdong province.Visual inspection with acetic acid(VIA) staining and iodine(VILI) staining were used generally,while the individuals with abnormal result were further performed colposcopy biopsy and pathologic diagnosis.The suspicious individuals screened out in 2008 were reexamined in 2009.The incidences of various grades of lesion tested by visual inspection screening and by the routine screening in our department were compared.Results The rates of compliance population in 2008 and 2009 were 33.38% and 50.71% respectively.The results from pathologic diagnosis on colposcopy biopsy in 2008 and 2009 were as following:normal cases were 52(86.67%) and 51(70.83%) respectively,cases with CIN I were 5(8.83%) and 11(15.28%) respectively,cases with CIN II were 1(1.67%) and 4(5.56%) respectively,cases with CIN III were 2(3.33%) and 5(6.94%) respectively,cases with cervical cancer were 0 and 1 respectively,and the rates of treatment were 33.33% and 30.00% respectively.The rate of reexamination in 2009 was 12.06%,of which pathologically diagnosed as normal were 2 cases(33.33%),CIN I were 3 cases(50.00%),CIN II was 1 case(16.67%) and none with CIN III.There was no statistical significance between the deference of the rates by visual inspection screening in 2008 and by the routine examination in our department,but the difference of the rates by visual inspection screening in 2009 and by the routine examination in our department was statistical significance(P<0.05).Conclusions Visual inspection with acetic acid staining for cervical cancer screening is a cost-effective method in the area where resources is limited and economy is underdeveloped.With propaganda and education of the knowledge on cervical cancer,the compliance of participation and treatment will increase which will make early diagnosis and treatment possible and then the incidence and mortality of cervical cancer will be reduced.

Key words: Cervical cancer, Visual inspection, Screening method, Rural area