CAJ | 학술논문

目的对醋酸染色后肉眼观察( VIA)与人乳头瘤病毒(HPV)、液基细胞学检查(TCT)宫颈癌筛查三种方案实用价值进行评价.方法采用VIA、HPV和TCT对946例女性进行筛查,任何一项存在阳性均进行阴道镜检查,必要时加宫颈四象限活检及宫颈管刮术,以病理结果为金标准,病理组织学结果≥CINⅡ为阳性.结果三种筛查方案灵敏度(73.1％、96.2％、88.5％)和阴性预测值(99.1％、99.9％、99.7％)差异均无统计学意义(均P ＞0.05)；TCT的特异度(97.5％)和阳性预测值(50.0％)明显优于HPV( 93.5％、29.4％),HPV优于VIA( 87.0％、13.7％),差异均有统计学意义(x2=71.34、26.00、22.17、8.28,均P＜0.05):HPV筛查方法发现真正的患者与非患者的总能力最强,TCT次之,VIA最差；VIA费用最低.结论尽管肉眼观察技术存在较高的漏诊和误诊,但其成本低廉,就成本效果分析与HPV及TCT方案相比仍有实用价值.
목적 대작산염색후육안관찰( VIA)여인유두류병독(HPV)、액기세포학검사(TCT)궁경암사사삼충방안실용개치진행평개.방법 채용VIA、HPV화TCT대946례녀성진행사사,임하일항존재양성균진행음도경검사,필요시가궁경사상한활검급궁경관괄술,이병리결과위금표준,병리조직학결과≥CINⅡ위양성.결과 삼충사사방안령민도(73.1％、96.2％、88.5％)화음성예측치(99.1％、99.9％、99.7％)차이균무통계학의의(균P ＞0.05)；TCT적특이도(97.5％)화양성예측치(50.0％)명현우우HPV( 93.5％、29.4％),HPV우우VIA( 87.0％、13.7％),차이균유통계학의의(x2=71.34、26.00、22.17、8.28,균P＜0.05):HPV사사방법발현진정적환자여비환자적총능력최강,TCT차지,VIA최차；VIA비용최저.결론 진관육안관찰기술존재교고적루진화오진,단기성본저렴,취성본효과분석여HPV급TCT방안상비잉유실용개치.
Objective To evaluate the values of visual inspection with acetic acid( VIA) and human papillomavirus( HPV) and thinprep cytology test( TCT) in the screening of cervical cancer.Methods VIA,HPV test and TCT in 946 women was conducted.Cervical biopsy or endocenical curettage( ECC) was performed in VIA positive women or HPV positive women or TCT positive women. The pathologic outcome was as the gold standard,and the out come more and equal to cervical intraepithelial neoplasia( CIN) Ⅱ were identified as positive.Results There was no significant difference among three groups in sensitivity rate( 73.l％,96.2,88.5％ ) and negative predictive value ( 99. 1％ ,99.9％ ,99.7％ ) ( all P ＞ 0.05 ).The specificity rate (97.5％ ) and positive predictive value ( 50.O％ ) of TCT was better than those of HPV ( 93.5％,29.4％ ),and HPV was better than those of VIA( 87.0％,13.7％ ),and the difference had statistifical significance among three groups ( x2 =71.34,26.00,22.17,8.28,all P ＜ 0.05 ).Conclusion Although the rate of missed diagnosis and misdiagnosis rate was higher than that of HPV and TCT,but VIA seems to be appropriate methods in the screening of cervical cancer owing to its low price.