徐国稚  梁燕梅

[摘 要] 目的 研究醋酸染色法（VIA）联合碘染色法（VILI）在宫颈病变筛查中的应用价值。 方法 对2011年1月～2013年12月来我院妇科就诊的30～60岁已婚妇女进行VIA和VILI法宫颈病变的筛查，对于结果异常者进行阴道镜组织活检病理诊断。 结果 2011年初查VIA或 VILI阳性325例，其中阴道镜下组织活检107例，确诊为CINⅠ及以上的病例50例，检出率2.94%（50/1698）；2012年首次复检VIA或 VILI阳性194例，其中阴道镜下组织活检63例，确诊为CINⅠ及以上的病例13例，检出率0.98%（13/1324）；2013年第二次复检VIA或 VILI阳性157例，其中阴道镜下组织活检42例，确诊为CINⅠ及以上的病例4例，检出率0.41%（4/996）。确诊的CINⅠ、CINⅡ、CINⅢ患者平均年龄分别为39.74岁（22例）、42.56岁（18例）、46.28岁（22 例）和49.80岁（5例）。 结论 VIA和VILI 法适合经济条件不发达区域进行宫颈病变的筛查。

[关键词] 宫颈病变；醋酸染色法；碘染色法；筛查

[中图分类号] R737.33   [文献标识码] B   [文章编号] 2095-0616（2014）08-97-03

Application value of acetic acid staining and iodine staining in screening of cervical lesions

XU Guozhi1  LIANG Yanmei2

1.Jindu County Health Center of Gaoyao City, Gaoyao 526108, China;2.People's Hospital of Gaoyao City, Gaoyao 526040, China

[Abstract] Objective To study the application value of acetic acid staining (VIA) combined with iodine staining (VILI) in the screening of cervical lesions. Methods Married women aged 30 to 60 years who were treated in the gynecology department of our hospital from January 2011 to December 2013 used VIA and VILI methods for the screening of cervical lesions. The women with abnormal results received colposcopic tissue biopsy pathological diagnosis. Results In 2011, the primary examination found 325 positive cases by VIA or VILI, of which 107 cases received colposcopic tissue biopsy and 50 cases were diagnosed as CIN I and above, with the detection rate of 2.94% (50/1698). In 2012, the first reexamination found 194 positive cases by VIA or VILI, of which 63 cases received colposcopic tissue biopsy and 13 cases were diagnosed as CIN I and above, with the detection rate of 0.98% (13/1324). In 2013, the second reexamination found 157 positive cases by VIA or VILI, of which 42 cases received colposcopic tissue biopsy and 4 cases were diagnosed as CIN I and above, with the detection rate of 0.41% (4/996). The average age of patients diagnosed with CIN I, CIN II and CIN III was 39.74 years (22 patients), 42.56 years (18 patients), 46.28 years (22 patients) and 49.80 years (5patients) respectively. Conclusion VIA and VILI methods are suitable for the screening of cervical lesions in economically underdeveloped regions.

[Key words] Cervical lesions; Acetic acid staining; Iodine staining; Screening

宫颈癌是常见的妇科恶性肿瘤，严重威胁女性健康，其发病率仅次于乳腺癌，在女性恶性肿瘤中居于第二[1-2]。早期诊断和及时治疗可以提高宫颈癌的治愈率，控制其病死率。目前，细胞学检查、人乳头状瘤病毒（HPV）检测以及阴道镜检查是最主要的筛查方法，但是上述检查需要专门设备与专业人员，检查的高成本使筛查无法在基层医疗单位及宫颈病变筛查项目中批量采用[3-4]。醋酸染色法（visual inspection with acetic acid，VIA）与碘染色法（visual inspection with Lugols iodine，VILI）是近年来得到认可的经济简易的筛查方法[5-6]。本文通过VIA和VILI方法对来我院妇科就诊的1698名健康妇女进行宫颈病变筛查。

1 资料与方法

1.1 一般资料

本研究以2011年1月～2013年12月来我院妇科就诊的1698名健康妇女为宫颈病变的筛查对象，年龄30～60岁，有性生活史，非月经期和妊娠期，无盆腔照射史以及无子宫切除史。……