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首页> 外文期刊>Bangladesh Journal of Medical Science >Early detection of cervical intraepithelial lesions by simple visual inspection after acetic acid among women in Rajshahi medical college hospital
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Early detection of cervical intraepithelial lesions by simple visual inspection after acetic acid among women in Rajshahi medical college hospital

机译：拉杰沙希医学院附属医院的女性在接受乙酸检查后，通过简单的目视检查，早期发现宫颈上皮内病变

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Aim: To evaluate the performance of visual inspection of acetic acid (VIA) in the detection of precancerous and early cancerous lesions of cervix. Materials and methods: Total 5593 eligible women who randomly came to the Gyenae out patient department (OPD) of RMCH (Rajshahi Medical College Hospital) were examined by VIA. Detection of well defined, opaque, acetowhite lesions close to the squamocolumner junction or in transitional zone or dense acetowhitening of ulceroproliferative growth on the cervix constituted a positive VIA. Those who had abnormal results in screening test & those who had clinically suspicious lesions were sent for colposcopic evaluation (n= 442) & directed biopsy were taken from colposcopically suspected areas (n=214). The final diagnosis was based on histology. Results: Out of 5593 patients, 442 (7.20%) were VIA positive. 442 patients were colposcopically evaluated .Among them, 228 (51.58%) were normal and 202(45.70%) had different stages of cervical intraepithelial lesions (CIN) and 12 ( 2.71 % ) had carcinoma of cervix. Out of 214 patients biopsied, 23.36 % patients had a final diagnosis of CIN lesions, 5 (2.33%) had carcinoma in-situ & 17 cases (7.94%) had invasive carcinoma. Besides to find out the predictable factors of cervical lesions data have been collected from VIA positive patients regarding age of first coitus and first delivery, history of extra marital exposure and STI, use of contraceptive methods and family history of cancer. Age of first coitus between 12 to 15 years and 16 to 20 years were observed among 203 (46 %) and 40 % (177) women respectively. More than half of the patients (62%) were experienced with their first delivery within the age 15-20 years which was below 15 years of 12 % (53) patients. Fifty four percent patients used OCP and barrier methods used were only 10 %. Family history of cancer was observed among 09 % women. 58% patients were belonged to lower middle class and upper group were only 9% (table 1) Conclusion: In our study detection of different grades of intraepithelial lesions (CIN-I, CIN-II, CIN-III, invasive carcinoma) of cervix by VIA was comparable to that of colposcopy. So VIA is suitable for detection of precursor lesions of cervical cancer in low resource settings and also for diagnosis, follow up treatment and epidemiological studies of cervical cancer.
机译：目的：评估目视检查乙酸（VIA）在检测宫颈癌前和癌前病变中的性能。材料和方法：共有5593名符合条件的妇女随机接受了RMCH（拉杰沙希医学院医院）的Gyenae门诊部（OPD）的检查。检测到明确的，不透明的，靠近鳞状结肠交界处或在过渡区或宫颈上的增生性增生的增白或增白的丙酮酸白斑构成了阳性VIA。将筛查结果异常的患者和具有临床可疑病变的患者送至阴道镜评估（n = 442），并从阴道镜检查可疑区域进行定向活检（n = 214）。最终诊断是基于组织学。结果：在5593名患者中，有442名（7.20％）的VIA阳性。 442例患者进行了阴道镜检查，其中228例（51.58％）正常，202例（45.70％）处于不同阶段的宫颈上皮内病变（CIN），12例（2.71％）患有宫颈癌。在214例活检患者中，有23.36％的患者最终诊断为CIN病变，其中5例（2.33％）为原位癌，17例（7.94％）为浸润性癌。除了找出宫颈病变的可预测因素外，还从VIA阳性患者中收集了有关首次性交年龄和首次分娩，婚外接触和性传播感染史，使用避孕方法以及癌症家族史的数据。分别在203（46％）和40％（177）名妇女中观察到初次性交的年龄在12至15岁和16至20岁之间。超过一半的患者（62％）在15至20岁之间经历首次分娩，而15％以下的患者为12％（53）患者。 54％的患者使用了OCP，使用的屏障方法仅为10％。在09％的女性中观察到了癌症的家族史。 58％的患者属于下中产阶级，上层的只有9％（表1）结论：在我们的研究中，检测到不同等级的宫颈上皮内病变（CIN-I，CIN-II，CIN-III，浸润性癌） VIA的效果与阴道镜检查相当。因此，VIA适用于在资源匮乏的情况下检测子宫颈癌的前体病变，也适用于子宫颈癌的诊断，后续治疗和流行病学研究。

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