电子阴道镜宫颈照相技术用于社区妇女宫颈癌筛查的价值

Value of electronic colposcopic cervicography used for cervical cancer screening in community women

目的:评价电子阴道镜宫颈照相技术作为社区妇女宫颈癌筛查的初筛工具的价值。方法:2007年10月～2008年6月由上海市虹口区新港社区卫生服务中心对来自新港社区2 505例30～59岁的妇女进行宫颈癌的筛查,筛查方案为:①肉眼观察(醋酸试验、碘试验)。②电子阴道镜宫颈照相。③巴氏涂片检查。对上述任何一项异常者行病理检查,将CINII及以上结果纳入阳性结果。结果:410例病理活检,检出CINⅠ17例,CINⅡ15例,CINⅢ4例,巴氏涂片、肉眼观察(VIA+VILI)、电子阴道镜宫颈照相、巴氏+肉眼、巴氏+宫颈照相、肉眼+宫颈照相诊断宫颈高级别病变的灵敏度分别为:31.6%、78.9%、94.7%、78.9%、94.7%、78.8%;特异度为97.4%、61.4%、76.2%、59.1%、73.6%、78.8%。结论:电子阴道镜宫颈照相的灵敏度高于巴氏涂片,特异度高于肉眼观察,该方法操作简单、价廉、可重复读片,可作为社区宫颈癌筛查的初筛方法之一。

Objective：To evaluate the value of electronic colposcopic cervicography（ECC） as a tool for primary screening method of cervical cancer in community women.Methods：From October 2007 to June 2008,Xingang community health service center of Hongkou district in Shanghai city conducted cervical cancer screening among 2 505 women aged 30-59 years old from Xingang community,screening programs included visual observation（acetic acid test and iodine test）,ECC,and Pap smear.The cases with abnormal results received pathological examination,CIN Ⅱ or above lesions were included into positive results.Results：Among 410 cases receiving pathological biopsy,17 cases with CIN Ⅰ,15 cases with CIN Ⅱ,and 4 cases with CIN Ⅲ were screened out,the sensitivities of Pap smear,visual observation,ECC,Pap smear＋visual observation,Pap smear＋ECC,visual observation＋ECC for diagnosis of high-grade CIN were 31.6%,78.9%,94.7%,78.9%,94.7%,and 78.8%,respectively;the specificities were 97.4%,61.4%,76.2%,59.1%,73.6%,and 78.8%,respectively.Conclusion：The sensitivity of ECC was higher than that of Pap smear,and the specificity of ECC was higher than that of visual observation.ECC is easy to operate,inexpensive,and repeatable,which can be used as one of primary screening methods for cervical cancer in community.