比较巴氏涂片、阴道镜和阴道镜筛查子宫颈癌前病变的效果

Mahin Fatima Faridi Khan, B. Gupta, M. Srivastava, Kusum Lata, Vibha Singh, Dr Twinkle
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引用次数: 0

摘要

宫颈癌是一项重大的公共卫生挑战,特别是在发展中国家,那里约有80%的病例得到诊断。尽管是一种可预防的疾病,但它仍然非常普遍,2020年全球报告了60多万新病例和34万例死亡。根据GLOBOCAN 2020的数据,宫颈癌占印度所有癌症病例的9.4%,占新发癌症病例的18.3%。然而,宫颈癌现在被认为是可以通过子宫颈检查预防和治愈的,特别是如果及早发现,这强调了"预防胜于治疗"的重要性。目前的研究使用巴氏涂片,VIA和阴道镜检查来识别指示癌的异常宫颈外观。在18个月的时间里,对329名在Integral Institute of Medical Sciences and Research医院门诊就诊的妇女进行了一项研究。在参与者的同意下,作为研究的一部分,这些女性接受了VIA、巴氏涂片和阴道镜检查。本研究中,经检阳性61例(18.5%),经检阴性268例(81.5%)。在本研究中,85.7%的子宫颈抹片检查正常,18.5%的子宫颈抹片检查阳性,77%的子宫颈抹片检查异常,23例(37.5%)ASC (NOS/US), 8例(13.1%)AGC和AGC NOS, 6例(9.1%)AEC, 5例(8.2%)LSIL, 5例(8.2%)HSIL, 268例(100%)VIA阴性,所有子宫颈抹片检查正常。共行阴道镜检查61例,其中VIA阳性18.5%,阳性73.6%,ⅰ期29例(47.5%),ⅲ期10例(16.3%),ⅱ期6例(9.8%),正常13.2%,宫颈炎13.2%。所有阴道镜患者均行活检,其中CIN为49.2%,慢性宫颈炎为27%,CIN为10%,鳞状细胞癌为3.2%,原位腺癌为1.6%,无异型性的为1.6%。VIA是细胞学检测子宫颈癌前病变的一种很有前途的替代方法,具有成本效益、现场结果、高灵敏度和特异性。在印度等资源匮乏的地区,大量妇女无法获得筛查测试,VIA尤其适合。这种筛查方法允许立即咨询和转诊治疗,有助于减少诊断和治疗的延误,从而有助于最大限度地减少诊断和治疗的延误。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
To compare the effectiveness of pap smear, via and colposcopy for screening of premalignant lesions of cervix
Cervical cancer poses a major public health challenge, particularly in developing nations, where around 80% of cases are diagnosed. Despite being a preventable disease, it remains highly prevalent, with over 600,000 new cases and 340,000 deaths reported worldwide in 2020. According to the GLOBOCAN 2020 data, cervical cancer represented 9.4% of all cancer cases and 18.3% of new cancer cases in India. However cervical cancer is now considered preventable through cervical screening and curable, particularly if detected early, which emphasizes the importance of "prevention is better than cure". The current research utilized Pap smear, VIA, and colposcopy to identify abnormal cervical appearances indicative of carcinoma.: During a span of 18 months, a study was carried out on 329 women who were attending the OPD clinic at Integral Institute Of Medical Sciences and Research hospital. With the participants' consent, the women underwent VIA, Pap smear and colposcopy tests as part of the study. In the study 61 (18.5%) cases were found positive in VIA findings and 268 (81.5%) were VIA negative. In this study 85.7% of Pap smears were normal, out of 18.5% VIA positive, 77% of pap smears were abnormal 23 (37.5%) ASC (NOS/US), 8 (13.1%) AGC and AGC NOS, 6 (9.1%) AEC, 5 (8.2%) LSIL, 5 (8.2%) HSIL and out of 268 VIA negative all Pap were normal (100%). 61 colposcopies were done, out of 18.5% VIA positive, 73.6% colposcopies were positive 29 were CIN I (47.5%), 10 were CIN III (16.3), 6 were CIN II (9.8%) and 13.2% were normal and 13.2% were cervicitis. Biopsy was done in all colposcopy patients, 49.2% were CIN I, 27% were chronic cervicitis, 10% were CIN I, 3.2% were squamous cell carcinoma and 1.6% were adenocarcinoma in situ and 1.6% were cx show no atypia. VIA offers a promising alternative to cytology for detecting premalignant lesions of the uterine cervix, with its cost-effectiveness, on-the-spot results, and high sensitivity and specificity. In low-resource settings like India, where a substantial number of women lack access to screening tests, VIA is especially well-suited. This screening method allows for immediate counseling and referral for treatment, helping to reduce delays in diagnosis and treatment which can help to minimize delays in diagnosis and treatment.
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