薄层液基宫颈细胞学检查与传统巴氏涂片检查的性能比较：一项定量调查。

Performance of ThinPrep liquid-based cervical cytology in comparison with conventionally prepared Papanicolaou smears: a quantitative survey.

作者信息

Abulafia Ovadia, Pezzullo John C, Sherer David M

机构信息

Department of Obstetrics and Gynecology, State University of New York at Brooklyn, Downstate Medical Center, 450 Clarkson Avenue, Box 24, Brooklyn, NY 11203, USA.

出版信息

Gynecol Oncol. 2003 Jul;90(1):137-44. doi: 10.1016/s0090-8258(03)00176-8.

DOI:10.1016/s0090-8258(03)00176-8

PMID:12821354

Abstract

OBJECTIVES

The goal of this study was to evaluate the performance of ThinPrep, a liquid-based cytology preparation technique, in comparison with conventionally prepared Papanicolaou smears in detecting cervical pathology.

METHODS

Forty-seven English-language articles published between January 1990 and September 2002 were identified through Medline and manual searches. After elimination of 5 nonprimary articles, 10 unpaired studies, 5 descriptive articles with insufficient or no data, and 3 articles with data that could not be recast into a consistent format, there remained 24 usable articles. Seventeen articles contained data comparing ThinPrep with conventional cytology for 35172 patients; and 10 articles compared cytology with histology or other gold standard diagnoses for 21752 patients. Three of these articles contained both types of comparisons. The standard cytology classification into negative, atypical, low-grade (LGSIL) and high-grade (HGSIL) squamous intraepithelial lesions, and carcinoma was applied; other categorization schemes were recoded as necessary. Concordance estimates, based on five-way and dichotomous (normal/abnormal) classifications, were obtained from the 17 studies containing paired cytology data. Sensitivity and specificity rates were obtained from the 10 studies with paired cytology and histology data.

RESULTS

The two methods tend to agree in 89 and 92% of cases based on the five-level and dichotomous classifications, respectively. ThinPrep was reported as normal in 93.5% of cases of normal conventional smears. The remaining 6.5% of ThinPrep slides were classified as follows: atypical, 4.55%; LGSIL, 1.56%; HGSIL, 0.36%; invasive cancer, 0.007%. Sensitivity rates, relative to histology, were 68% (conventional) and 76% (ThinPrep), and specificity rates were 79% (conventional) and 86% (ThinPrep).

CONCLUSION

ThinPrep tends to be more sensitive and specific than conventional smears in detecting cervical dysplasia. The increased sensitivity of ThinPrep results in increased cytologic diagnosis of cervical atypia, LGSIL, HGSIL, and invasive cervical carcinoma.

摘要

目的

本研究的目的是评估液基细胞学制片技术ThinPrep与传统巴氏涂片在检测宫颈病变方面的性能。

方法

通过医学在线数据库（Medline）检索及手工检索，确定了1990年1月至2002年9月发表的47篇英文文章。剔除5篇非原始文章、10篇非配对研究、5篇数据不足或无数据的描述性文章以及3篇数据无法整理成一致格式的文章后，剩下24篇可用文章。17篇文章包含了比较ThinPrep与传统细胞学检查的35172例患者的数据；10篇文章比较了细胞学检查与组织学检查或其他金标准诊断的21752例患者的数据。其中3篇文章包含了这两种类型的比较。应用标准的细胞学分类，分为阴性、非典型、低级别（低度鳞状上皮内病变，LGSIL）和高级别（高度鳞状上皮内病变，HGSIL）鳞状上皮内病变以及癌；必要时对其他分类方案进行重新编码。从17项包含配对细胞学数据的研究中获得基于五级和二分法（正常/异常）分类的一致性估计。从10项具有配对细胞学和组织学数据的研究中获得敏感性和特异性率。

结果

基于五级和二分法分类，两种方法在89%和92%的病例中趋于一致。在传统涂片正常的病例中，93.5%的ThinPrep涂片报告为正常。其余6.5%的ThinPrep涂片分类如下：非典型，4.55%；LGSIL，1.56%；HGSIL，0.36%；浸润癌，0.007%。相对于组织学检查，敏感性率分别为68%（传统方法）和76%（ThinPrep），特异性率分别为79%（传统方法）和86%（ThinPrep）。