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目的:探索适合西部农村地区宫颈癌的筛查方法,为该区乃至全国经济欠发达地区推行简便、价廉、易行的宫颈癌筛查方法提供科学的依据。方法:该区30个乡镇符合条件的农村妇女签署知情同意书后,接受基本情况问卷调查,用醋酸染色后肉眼观察及碘染色肉眼观察进行宫颈检查,结果异常者上转该院行阴道镜检查,并得出最终病理结果诊断。以病理结果为金标准,对醋酸染色后肉眼观察/碘染色肉眼观察诊断效果进行评价。结果:在筛查53 039例35～59岁的人群中,4 068例结果异常上转该院行阴道镜检查,1 610例做病理组织学活检,诊断为宫颈上皮内瘤变I级以上患者86例,患病率1.62‰(86/53 039),5%醋酸/碘染色肉眼观察的灵敏度、特异度分别为:84.6%、99.1%(醋酸肉眼观察);81.1%、99.1%(碘染色肉眼观察)。结论:在中国经济落后、技术受限的地区,进行简单、快捷、经济的肉眼观察法做宫颈癌筛查具有可行性。
Objective: To explore a screening method suitable for cervical cancer in western rural areas and to provide a scientific basis for the implementation of a simple, inexpensive and easy cervical screening method in economically underdeveloped areas in the district. Methods: The eligible rural women in 30 towns and villages in the district signed the informed consent form and accepted the questionnaire survey of the basic situation. The cervical examination was performed with macroscopic observation and iodine staining with acetic acid staining. The results showed that the abnormalities were transferred to the hospital for colposcopy examination, And draw the final pathological diagnosis. Pathological results as the gold standard, acetic acid staining macroscopic observation / iodine staining macroscopic evaluation of diagnostic results were evaluated. Results: Among 53 039 35- 59-year-olds, 4 068 cases were abnormally turned into colposcopy and 1 610 cases were histopathologically biopsy. Those with grade I or higher cervical intraepithelial neoplasia The sensitivity and specificity of 5% acetic acid / iodine staining were 84.6%, 99.1% (acetic acid macroscopic observation); 81.1%, 99.1% (iodine staining Visual observation). Conclusion: It is feasible to screen cervical cancer easily, quickly and economically in China’s economically backward and technology-restricted areas.