Zhang Fred Fangyuan, Banks Helen Whitler, Langford Shanna Maria, Davey Diane Davis
Department of Pathology and Laboratory Medicine, University of Kentucky, Lexington, KY 40536-0298, USA.
Arch Pathol Lab Med. 2007 May;131(5):773-6. doi: 10.5858/2007-131-773-AOTISI.
The ThinPrep Imaging System (Imager) for cervical cytology is used in many US laboratories, but the ability of the system to identify classic changes of low-grade squamous intraepithelial lesion (LSIL) has not been independently reported.
To evaluate the accuracy of this system in detecting classic LSIL cells.
A total of 114 imaged ThinPrep LSIL cases from April to June 2005 were reviewed to determine whether the most diagnostically relevant cells were present in the 22 fields selected by Imager. Those LSIL specimens from January to June 2005 that were initially screened by the Imager and classified as "negative" in the 22 fields were also reviewed. The average number of classic koilocytes per slide was compared among cases that had koilocytes within 22 fields with cases upgraded during full review.
Twelve (10.5%) of 114 LSIL cases from April to June 2005 did not show diagnostic LSIL cells within the initial 22 fields. Full manual rescreening was performed on 1025 cases from January to June (20.4% of negative cases). Nine cases that were initially negative in the 22 fields were revised to LSIL (2.4% of all 381 LSIL cases reported from January to June 2005). An average of 10 to 11 koilocytes were present in these 2 groups, which was significantly lower than the average of 75 koilocytes in cases in which the 22 Imager-selected fields showed LSIL.
Although the ThinPrep Imager finds abnormal cells in most LSIL cases, the system may have limitations in detecting koilocytes in the 22 Imager-selected fields. When 10% quality control rescreening is performed as required by federal regulations, full manual rescreening will provide the most accurate results.
用于宫颈细胞学检查的ThinPrep成像系统在美国许多实验室中使用，但该系统识别低级别鳞状上皮内病变（LSIL）典型变化的能力尚未有独立报道。
评估该系统检测典型LSIL细胞的准确性。
回顾了2005年4月至6月间114例经成像的ThinPrep LSIL病例，以确定成像系统选择的22个视野中是否存在最具诊断意义的细胞。还回顾了2005年1月至6月间最初经成像系统筛查并在22个视野中分类为“阴性”的那些LSIL标本。比较了在22个视野中有挖空细胞的病例与全面复查时升级的病例中每张玻片上典型挖空细胞的平均数量。
2005年4月至6月间的114例LSIL病例中有12例（10.5%）在最初的22个视野中未显示诊断性LSIL细胞。对2005年1月至6月间的1025例病例（占阴性病例的20.4%）进行了全面手工复查。22个视野最初为阴性的9例病例被修订为LSIL（占2005年1月至6月间报告的所有381例LSIL病例的2.4%）。这两组中平均有10至11个挖空细胞，显著低于成像系统选择的22个视野显示LSIL的病例中平均75个挖空细胞的数量。
尽管ThinPrep成像系统在大多数LSIL病例中能发现异常细胞，但该系统在成像系统选择的22个视野中检测挖空细胞时可能存在局限性。按照联邦法规要求进行10%的质量控制复查时，全面手工复查将提供最准确的结果。
