A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol's Iodine for cervical cancer screening in HIV-infected women.
A randomized trial comparing the diagnostic accuracy of visual inspection with acetic acid to Visual Inspection with Lugol's Iodine for cervical cancer screening in HIV-infected women.
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DOI：
10.1371/journal.pone.0118568
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Cohen CR
中科院分区：
文献类型：
--
作者：
Huchko MJ;Sneden J;Zakaras JM;Smith-McCune K;Sawaya G;Maloba M;Bukusi EA;Cohen CR
在低资源环境中，各种宫颈癌筛查方案越来越多地推荐使用醋酸（VIA）和卢戈碘（VILI）进行目视检查。虽然VIA的使用更为广泛，但VILI一直被认为是一种更简单、更特异的筛查方法。与VIA相比，VILI作为一种独立的筛查试验尚未得到充分验证，也未被验证可用于HIV感染的妇女。我们进行了一项随机临床试验，比较VIA和VILI在HIV感染妇女中的诊断准确性。参加肯尼亚西部家庭艾滋病护理和教育服务（FACES）诊所的妇女被招募并随机接受阴道镜检查的VIA或VILI。对疑似宫颈上皮内瘤变2级或以上（CIN2+）的病变进行活检。在2011年10月至2012年6月期间，654例患者被随机分配接受VIA或VILI。VIA和VILI的检测阳性率分别为26.2%和30.6%（p = 0.22）。VIA组和VILI组的CIN2+检出率分别为7.7%和11.5%（p = 0.10）。VIA和VILI检测CIN2+的诊断性能无显著差异。VIA的敏感性和特异性分别为84.0%和78.6%，VILI为84.2%和76.4%。VIA的阳性和阴性预测值分别为24.7%和98.3%，VILI为31.7%和97.4%。在CD4+计数< 350的女性中，VILI的特异性（66.2%）显著低于同组的VIA（83.9%，p = 0.02）和CD4+计数≥ 350的女性中进行的VILI（79.7%，p = 0.02）。VIA和VILI在HIV感染妇女中具有相似的诊断准确性和CIN2+检测率。ClinicalTrials.gov www.example.com
Visual inspection with Acetic Acid (VIA) and Visual Inspection with Lugol’s Iodine (VILI) are increasingly recommended in various cervical cancer screening protocols in low-resource settings. Although VIA is more widely used, VILI has been advocated as an easier and more specific screening test. VILI has not been well-validated as a stand-alone screening test, compared to VIA or validated for use in HIV-infected women. We carried out a randomized clinical trial to compare the diagnostic accuracy of VIA and VILI among HIV-infected women. Women attending the Family AIDS Care and Education Services (FACES) clinic in western Kenya were enrolled and randomized to undergo either VIA or VILI with colposcopy. Lesions suspicious for cervical intraepithelial neoplasia 2 or greater (CIN2+) were biopsied. Between October 2011 and June 2012, 654 were randomized to undergo VIA or VILI. The test positivity rates were 26.2% for VIA and 30.6% for VILI (p = 0.22). The rate of detection of CIN2+ was 7.7% in the VIA arm and 11.5% in the VILI arm (p = 0.10). There was no significant difference in the diagnostic performance of VIA and VILI for the detection of CIN2+. Sensitivity and specificity were 84.0% and 78.6%, respectively, for VIA and 84.2% and 76.4% for VILI. The positive and negative predictive values were 24.7% and 98.3% for VIA, and 31.7% and 97.4% for VILI. Among women with CD4+ count < 350, VILI had a significantly decreased specificity (66.2%) compared to VIA in the same group (83.9%, p = 0.02) and compared to VILI performed among women with CD4+ count ≥ 350 (79.7%, p = 0.02). VIA and VILI had similar diagnostic accuracy and rates of CIN2+ detection among HIV-infected women. ClinicalTrials.gov NCT02237326
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DOI：
10.1016/j.bpobgyn.2011.08.003
发表时间：
2012-04-01
影响因子：
5.5
作者：
Sankaranarayanan, Rengaswamy;Nessa, Ashrafun;Dangou, Jean-Marie
通讯作者：
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影响因子：
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DOI：
10.1016/j.ijgo.2011.02.009
发表时间：
2011-08-01
影响因子：
3.8
作者：
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Cohen, Craig R.