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首页> 外文期刊>Indian Journal of Medical and Paediatric Oncology >Comparative study of effectiveness of Pap smear versus visual inspection with acetic acid and visual inspection with Lugol's iodine for mass screening of premalignant and malignant lesion of cervix
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Comparative study of effectiveness of Pap smear versus visual inspection with acetic acid and visual inspection with Lugol's iodine for mass screening of premalignant and malignant lesion of cervix

机译：子宫颈抹片检查与醋酸肉眼检查和卢戈尔碘肉眼检查对子宫颈癌前病变和恶性病变的有效性比较研究

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Background and Objective:Cancer of the cervix is a leading cause of morbidity and mortality among women worldwide. Therefore, to curb the disease, there is a need to develop a screening test that has good sensitivity and specificity. The present study is aimed to compare the effectiveness of the Pap smear, visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI) for mass screening of premalignant and malignant lesions of the cervix; to evaluate the usefulness of VIA and VILI as an adjunct to improve sensitivity of cervical cytology; and to evaluate the role of VILI as a parallel screening method with VIA to enhance its test performance.Design and Setting:This was a prospective, analytical study in which 210 patients of the reproductive age group attending the gynecology OPD were enrolled.Patients and Methods:Patients were first subjected to Pap smear followed by VIA, VILI, colposcopy and biopsy for confirmation of lesion, if needed. Data was obtained and statistically analyzed.Results:Of the 210 patients, 34 (16.27%) had positive Pap test, 29 (13.87%) had positive VIA and 24 (11.43%) had positive VILI and 31 (14.75%) showed features of cervical intraepithelial neoplasia (CIN) on colposcopy. Of the total of 48 patients in whom either of the screening tests was positive and had undergone cervical biopsy, one had CIN-3, three had CIN-2, 12 had CIN-1, three had carcinoma in situ CIS and 29 reported normal. In our study, 40 patients were picked up as positive by combination of these tests, of which 19 (47.50%) had CIN on biopsy.Conclusion:Our study showed that VIA and VILI had sensitivity comparable to Pap smear and can thus be a suitable potential alternative/adjunctive screening test not only in a resource-poor setting but in well-equipped centers also. And, use of a combination of tests (Pap+VIA+VILI) had 100% sensitivity but at cost of low specificity and more false-positive results.
机译：背景与目的：宫颈癌是全球女性发病和死亡的主要原因。因此，为了遏制该疾病，需要开发具有良好敏感性和特异性的筛选试验。本研究旨在比较宫颈涂片涂片检查，醋酸肉眼检查（VIA）和卢格氏碘肉眼检查（VILI）对子宫颈癌前病变和恶性病变进行大规模筛查的有效性;评估VIA和VILI作为辅助剂以提高宫颈细胞学敏感性的有用性;设计和设置：这是一项前瞻性分析研究，其中招募了210名接受妇科OPD治疗的育龄组患者。 ：如果需要，首先对患者进行子宫颈抹片检查，然后进行VIA，VILI，阴道镜检查和活检以确认病变。结果：在210例患者中，巴氏试验阳性34例（16.27％），VIA阳性29例（13.87％），VILI阳性24例（11.43％），有31例（14.75％）表现为特征。阴道镜检查宫颈上皮内瘤变（CIN）。在任何一项筛查试验均为阳性并进行了宫颈活检的48例患者中，有1例为CIN-3、3例为CIN-2、12例为CIN-1、3例为原位癌，而29例报告为正常。在我们的研究中，通过这些检查的组合将40例患者检出为阳性，其中19例（47.50％）的活检组织为CIN。结论：我们的研究表明，VIA和VILI的敏感性与巴氏涂片相当，因此可能适合潜在的替代/辅助筛查测试不仅在资源匮乏的地区，而且在设备齐全的中心也是如此。并且，结合使用多种测试（Pap + VIA + VILI）具有100％的敏感性，但代价是特异性低且假阳性结果更高。

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