Bulk S, Van Kemenade F J, Rozendaal L, Meijer C J L M
Department of Pathology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
J Clin Pathol. 2004 Apr;57(4):388-93. doi: 10.1136/jcp.2003.011841.
To describe the effect of introducing the CISOE-A framework for reporting cervical cytology results, including changes in repeat and referral advice in the Netherlands, on the efficacy of the screening programme. Changes in the distribution of cytological results, the detection rate of cervical intraepithelial neoplasia (CIN) lesions, and the detection rate of squamous cervical carcinoma are reported.
The results of all gynaecology cytological and histological examinations, as registered in the nationwide database for histopathology and cytopathology (PALGA) from 1990 to 2000, were retrieved from seven laboratories in the greater Amsterdam area.
After the introduction of the CISOE-A classification, cytological results with equivocal diagnoses decreased significantly from 11.3% to 2.6%, without an increase in the percentages of moderate dyskaryosis or worse. During the study period, the detection rate of histologically diagnosed high grade CIN lesions increased significantly from 4.1 to 6.4/1000 smears, whereas there was no change in the detection rates of low grade lesions or invasive cervical cancer.
The introduction of the new CISOE-A classification system resulted in a substantial decrease of equivocal results and repeat recommendations, without a decrease in the detection rate of high grade lesions, making the screening programme more efficacious.
描述引入用于报告宫颈细胞学检查结果的CISOE-A框架（包括荷兰重复检查和转诊建议的变化）对筛查计划效果的影响。报告细胞学检查结果的分布变化、宫颈上皮内瘤变（CIN）病变的检出率以及宫颈鳞癌的检出率。
从1990年至2000年在全国组织病理学和细胞病理学数据库（PALGA）中登记的所有妇科细胞学和组织学检查结果，取自阿姆斯特丹大区的七个实验室。
引入CISOE-A分类后，诊断不明确的细胞学检查结果从11.3%显著降至2.6%，中度核异质或更严重情况的百分比没有增加。在研究期间，组织学诊断的高级别CIN病变的检出率从4.1/1000涂片显著增加至6.4/1000涂片，而低级别病变或浸润性宫颈癌的检出率没有变化。
新的CISOE-A分类系统的引入导致不明确结果和重复建议大幅减少，而高级别病变的检出率没有降低，使筛查计划更有效。
