VIAVILI肉眼观察法用于经济欠发达地区宫颈病变诊断价值研究.docVIP

VIAVILI肉眼观察法用于经济欠发达地区宫颈病变诊断价值研究 　　【摘要】目的：探讨VIA-VILI肉眼观察法用于贫困山区宫颈病变诊断中的临床价值。方法：对2007年7月至2009年1月在怀化市第三人民医院就诊的11200名就诊患者中进行醋酸肉眼观察法VIA5600名及复方碘染色肉眼观察法VILI5600名，对发现异常的患者进行阴道镜病理检查。结果：5600名肉眼观察患者中检出VIA阳性者291例（5.19%），其中，180例阴道镜病理检查为CIN II者20例，CIN III级或以上者8例，VILI阳性者281例（5.01%），其中177名阴道镜病理检查为CIN II级者19例，CIN II级者或以上者8例，发现VIA对CIN II和CIN III级以上的检测敏感度为79%-83%.VILI的敏感度为85%和84%.结论：VIA VILI肉眼观察法适用于筛查和诊断子宫颈癌前病变的可靠手段，因此特别是对经济欠发达地区，往往没有细胞学诊断的医生，缺乏薄层液基细胞学和HPV检测的设备和技术。综合考虑设备需求和经济条件等原因，VIA和VILI是简单，便宜，技术含量低的筛查方法①。 　　【关键词】VIA VILI 宫颈上皮内瘤变 活组织检查 　　 　　【Abstract】objective .To investigate the value by VIA-VILI in diagnosis of cervical disease in poor area women. Methods from 2007 to 2009 . 11200women who receive examination by VIA-VILI. If abnormal cgtogical results were found, those women were administered by colposcopit examination and biopsy after the signed informed consent.Results: 1.VIA: the abnormal results of 291(5.19%) women were found in 5600 cases. VILI: the abnormal results of281(5.01%) women were found in 5600 cases. The results of biopsy guided by colposcopy : VIA: among 280 cases it was found 20 cases with CINII. 8 cases with CINIII and scc. VILI: among 177 cases , it was found 19 cases with CINII, 8 cases with CINIII and scc. The rate of concordance in examination CIN II, CIN III and scc by VIA was 79%,83%,VILI was 85% ,84%.Condusions ：VIA-VILI to apply and cervical cancer initial diagnosis and reliable means of the disease, particularly on the economy developed areas, owing to not caryologia diagnosis, the lack of a thin layer of the base caryologia and hpv detection equipment and technical equipment. integrated consider demand and economic conditions, VIA-VILI is simple and cheap, low-technical initial testmethod 　　【key words】 cervical intraepithelial neoplasiaVIA-VILI Biopsy. 　　 　　子宫颈癌的发病率在女性恶变肿瘤中位居第二，仅次于乳腺癌，严重威胁着妇女的健康。由于宫颈癌存在着一个较长的，可逆转的癌前病变期。从宫颈癌前病变（CIN）发展为宫颈癌需5-10年时间②，我国每年新增病例占全世界发病人数的1/3,近年来宫颈癌的发病率有明显上升和年轻化的趋势.发病率以每年2%-3%的速度增长③.宫颈癌是目前唯一可以早期发现并能治愈的妇科癌症.因此早期发现宫颈癌前病变是