Cheung Annie N Y, Szeto Elaine F, Leung Betty S Y, Khoo Ui-Soon, Ng Anita W Y
Department of Pathology, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Cancer. 2003 Dec 25;99(6):331-5. doi: 10.1002/cncr.11786.
This study compared the findings of cervical cytology screening by ThinPrep Papanicolaou (Pap) tests (TP) with the findings of screening by conventional cervical smears (CS) in a screening population involving what to the authors' knowledge is the largest sample of ThinPrep Pap tests published to date.
Data from 191,581 CS that were screened in the period from March 1, 1998 to February 28, 2000 were compared with data from 190,667 TP performed from March 1, 2000 to February 28, 2002 and that were obtained from the same sources.
With TP, the unsatisfactory rate was reduced from 0.48% to 0.32%. Fewer cases were considered to be suboptimal (19.12% vs. 12.97%). The detection rates of squamous cell carcinomas, adenocarcinomas, and high-grade squamous intraepithelial lesions (HSIL) were essentially unchanged in the TP group (0.005%, 0.003%, and 0.25%, respectively) compared with the rates for the CS group (0.01%, 0.006%, and 0.25%, respectively). There was an increase in the detection of atypical squamous cells of undetermined significance (ASCUS; 3.74% vs. 3.19%) and low-grade SIL (LSIL; 1.67% vs. 1.01%) with a decrease in the ASCUS-to-LSIL ratio from 3.15 for CS to 2.33 for TP. The detection of atypical glandular cells of undetermined significance (AGUS) increased slightly from 0.07% to 0.09%. The proportion of cells reported to have reactive atypia dropped from 2.71% to 1.48%. Limited biopsy correlation (range, 73.2-76.2%) confirmed the increased sensitivity of TP. More actinomyces (1.07% vs. 0.52%) were detected in TP samples despite of a similar portion of intrauterine-device users. The average primary screening and rapid rescreening time of each slide were reduced from 8 minutes to 4 minutes and from 2 minutes to less than 1 minute, respectively.
The preliminary experience of the authors of the current study appears to support the use of the ThinPrep Pap test to enhance the efficiency of cervical cytology screening.
本研究在一个筛查人群中，将液基薄层巴氏试验（TP）进行宫颈细胞学筛查的结果与传统宫颈涂片（CS）筛查的结果进行了比较。据作者所知，该筛查人群包含了迄今为止已发表的最大规模的液基薄层巴氏试验样本。
将1998年3月1日至2000年2月28日期间进行筛查的191,581例传统宫颈涂片数据，与2000年3月1日至2002年2月28日期间来自相同来源的190,667例液基薄层巴氏试验数据进行比较。
采用液基薄层巴氏试验时，不满意率从0.48%降至0.32%。被认为次优的病例减少（19.12%对12.97%）。与传统宫颈涂片组相比，液基薄层巴氏试验组鳞状细胞癌、腺癌和高级别鳞状上皮内病变（HSIL）的检出率基本未变（分别为0.005%、0.003%和0.25%）。意义不明确的非典型鳞状细胞（ASCUS；3.74%对3.19%）和低级别鳞状上皮内病变（LSIL；1.67%对1.01%）的检出率有所增加，ASCUS与LSIL的比例从传统宫颈涂片的3.15降至液基薄层巴氏试验的2.33。意义不明确的非典型腺细胞（AGUS）的检出率略有增加，从0.07%升至0.09%。报告有反应性非典型性的细胞比例从2.71%降至1.48%。有限的活检相关性（范围为73.2 - 76.2%）证实了液基薄层巴氏试验的敏感性增加。尽管宫内节育器使用者比例相似，但在液基薄层巴氏试验样本中检测到更多放线菌（1.07%对0.52%）。每张玻片的平均初次筛查和快速复查时间分别从8分钟降至4分钟，从2分钟降至不到1分钟。
本研究作者的初步经验似乎支持使用液基薄层巴氏试验来提高宫颈细胞学筛查的效率。
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