Stewart Jimmie, Miyazaki Kayo, Bevans-Wilkins Kristen, Ye Changhong, Kurtycz Daniel F I, Selvaggi Suzanne M
Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
Cancer. 2007 Aug 25;111(4):203-9. doi: 10.1002/cncr.22766.
The objective of this study was to investigate the potential of virtual microscopy (VM) as an avenue for the delivery of mandatory cytology proficiency tests).
Three senior cytotechnologists and 2 board-certified cytopathologists participated in 3 virtual proficiency tests. Each set consisted of 10 ThinPrep slides that were digitized by an Aperio T3 ScanScope. The cytologic diagnoses covered the range of interpretive guidelines provided by the Centers for Medicare and Medicaid Services (CMS). Each cytotechnologist followed the requirement of a primary screener with the cytopathologists utilizing the secondary screener option.
Analysis of the diagnostic interpretation of the first proficiency test showed correct classification of 100% of normal and abnormal cells for primary and secondary screeners. The second proficiency test analysis revealed a 93.3% correct classification (100% using CMS guidelines) among the primary screeners. The secondary screeners gave a 100% correct classification. The final proficiency test had primary screeners and secondary screeners with 100% correct classification.
The current results confirmed the feasibility of VM for proficiency tests with 2 main problems noted. First, primary screeners had difficulties meeting the mandatory time allocation; however, with increased familiarity with the software, the screening times decreased. Second, the 3-dimensional nature of certain lesions made them difficult to interpret even on monolayered, liquid-based preparations. Creation of a more user-friendly software interface and better methods to capture depth of focus should make this a valid measure of cervicovaginal cytopathologic interpretive competence.
本研究的目的是探讨虚拟显微镜检查（VM）作为进行强制性细胞学能力验证测试途径的潜力。
三名资深细胞技术专家和两名获得委员会认证的细胞病理学家参加了三项虚拟能力验证测试。每组包括10张由Aperio T3 ScanScope数字化的ThinPrep玻片。细胞学诊断涵盖了医疗保险和医疗补助服务中心（CMS）提供的解释性指南范围。每位细胞技术专家遵循初级筛查人员的要求，细胞病理学家则使用二级筛查选项。
对第一次能力验证测试的诊断解释分析显示，初级和二级筛查人员对正常和异常细胞的分类正确率均为100%。第二次能力验证测试分析显示，初级筛查人员的正确分类率为93.3%（使用CMS指南时为100%）。二级筛查人员的正确分类率为100%。最后一次能力验证测试中，初级和二级筛查人员的正确分类率均为100%。
目前的结果证实了VM用于能力验证测试的可行性，但也指出了两个主要问题。首先，初级筛查人员难以满足规定的时间分配；然而，随着对软件的熟悉程度提高，筛查时间有所减少。其次，某些病变的三维性质使得即使在单层液基制片上也难以解释。创建更用户友好的软件界面以及更好的聚焦深度捕捉方法应能使VM成为宫颈阴道细胞病理学解释能力的有效衡量标准。
