醋酸白试验结合阴道镜在宫颈癌普查中的应用

Application of VIA combined with colposcopy in screening of cervical cancer

目的探讨运用醋酸白试验肉眼观察结合阴道镜指导下取活检的方法进行宫颈癌筛查。方法对宫颈醋酸白试验阳性者行阴道镜检查，并做多点活检、组织学诊断，结合两种检查结果综合分析宫颈癌筛查阳性率及准确性。结果共筛查2062．＆，受检率为61．52％，确诊宫颈上皮内瘤样病变Ⅰ级5例、Ⅱ级3例、Ⅲ及原位癌4例、宫颈腺癌1例，病检阳性率为9．85％，醋酸白肉眼试验肉眼观察结合阴道镜指导下取活检在宫颈癌普查中提高了宫颈上皮内瘤样病变的诊断准确率。结论该方法费用低，易操作，适合在边远贫困地区大范围的宫颈癌普查，值得推广。

Objective To investigate clinical value of visual inspection with acetic acid （VIA） combined with colposcopic biopsy in screening of cervical cancer. Methods The women who had positive results in VIA received colposcopy and multi-point biopsy for histopathological diagnosis. The positive rate and accuracy of VIA combined with colposcopy for cervical cancer were analyzed comprehensively. Results 2 062 women were screened and the screening rate was 61.51%. 5 cases of CIN Ⅰ , 3 cases of CIN Ⅱ , 4 cases of CINm and 1 case of cervical carcinoma in situ and 1 case of adenocarcinoma of uterine cervix were diagnosed. The positive rate of pathological examination was 9. 85%. Conclusion VIA combined with colposcopic biopsy can improve diagnostic accuracy of CIN in screening of cervical cancer and is cheaper and easy to be operated. So, it is worthy to be popularized in large scale screening of cervical cancer in poor countryside areas.