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背景与目的:目前,宫颈癌发病率在我国一些经济落后地区仍较高。原因之一是在这些地区难以开展宫颈细胞学涂片检查宫颈癌的普查工作。本研究通过分析应用醋酸涂抹法检测宫颈上皮内瘤样病变(cervicalintraepithelialneoplasia,CIN)及宫颈癌的敏感性和特异性,从而评价其在宫颈癌筛查中的应用价值。方法:对山西省襄垣县年龄为35～45岁的1997名妇女进行宫颈癌普查,首先应用5%醋酸涂抹法,同时对每名妇女均进行高危型人乳头状瘤病毒(humanpapillomavirus,HPV)DNA的检查、液基细胞学及阴道镜检查,在阴道镜下对病变区或每个正常象限的宫颈鳞柱上皮交界处的2、4、8、10点取活检,并行宫颈管刮出物病检,病理检查结果为金标准。结果:病理检查证实CINⅡ级43例,CINⅢ级31例,宫颈浸润癌12例。2例妇女仅颈管刮出物阳性,其中1例为CINⅡ级,另1例为CINⅢ级。醋酸涂抹法诊断结果为:正常1445例(72.4%),低度病变525例(26.3%),高度病变21例(1.0%),宫颈癌6例(0.3%)。醋酸涂抹法诊断为低度病变或其以上病变者中,经病理检查证实为CINⅡ级及其以上病变的检出敏感性为70.9%(61/86),特异性为74.3%(1420/1911),对小病灶的敏感性为64.9%(37/57),而大的病灶达88.9%(24/27)。阴道镜对高度病变的检出率为81.4%(70/86),特异性为76.5%(1462/19
Background and Objective: At present, the incidence of cervical cancer is still high in some economically backward areas in China. One of the reasons is that it is difficult to carry out a census of cervical cancer in these areas. In this study, the application of acetic acid smear method to detect cervical intraepithelial neoplasia (CIN) and cervical cancer sensitivity and specificity, and evaluate its value in cervical cancer screening. Methods: A total of 1997 women aged 35-45 years old in Xiangyuan County of Shanxi Province were enrolled in the cervical cancer screening test. At first, a 5% acetic acid smear method was applied. At the same time, each woman was given high-risk HPV (human papillomavirus) DNA , Liquid-based cytology and colposcopy, colposcopy lesions in the area or normal quadrant of cervical squamous epithelium junction 2, 4, 8 and 10 to take biopsy, and cervical scraping disease Inspection, pathological examination results for the gold standard. Results: Pathological examination confirmed 43 cases of CIN Ⅱ grade, 31 cases of CIN Ⅲ grade, 12 cases of invasive cervical carcinoma. Only 2 cases of women had positive cervical canal scraping, of which 1 was CIN II and the other 1 was CIN III. The results of acetic acid smear method were 1445 cases (72.4%), 525 cases (26.3%) of low grade, 21 cases (1.0%) of high grade and 6 cases of cervical cancer (0.3%). Acetic acid smear method for the diagnosis of low-grade lesions or more lesions were confirmed by pathological examination for CIN level Ⅱ and above lesions detection sensitivity was 70.9% (61/86), the specificity was 74.3% (1420/1911) , The sensitivity of small lesions was 64.9% (37/57), while the large lesions of 88.9% (24/27). Colposcopy for the detection of high-grade lesions was 81.4% (70/86), the specificity was 76.5% (1462/19