Laiwejpithaya Somsak, Rattanachaiyanont Manee, Benjapibal Mongkol, Khuakoonratt Nathaya, Boriboonhirunsarn Dittakran, Laiwejpithaya Sujera, Sangkarat Suthi, Wongtiraporn Weerasak
Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Asian Pac J Cancer Prev. 2008 Oct-Dec;9(4):575-80.
This study aimed to evaluate the correlation and agreement between Siriraj liquid-based cervical cytology (Siriraj -LBC) and conventional cytology. A total of 479 women who attended the Department of Obstetric and Gynaecology Siriraj Hospital for cervical cancer screening were enrolled. For each woman collection of cervical cells was performed using VCE technique. After smearing cells on a glass slide for conventional cytology, both broken ends of wooden spatula and cotton swabs were then placed into a plastic vial containing a specific preservative solution for Siriraj-LBC. All specimens were prepared and interpreted by experienced cytotechnologists at the Gynecologic Cytology Unit. Interpretations of the results from one technique were made without knowledge of those from the other technique. The results from both techniques were compared for agreement and correlation. Colposcopy or histology was used as the gold standard. The overall detection rate of abnormal cervicovaginal cells was higher by Siriraj-LBC than by conventional cytology (11.1% vs. 1.67%, P <0.001). These two techniques had high diagnostic agreement of 89.77%, and minimal to fair correlation with a Kappa of 0.128 (P<0.001) and a Spearman rho correlation coefficient of 0.394 (P <0.001). There were 49 cases whose Siriraj-LBC revealed higher cytologic grading than did the conventional cytology; there were no cases of the opposite result. The gold standard was available in 45 cases with abnormal cytology by Siriraj-LBC, revealing a positive predictive value (PPV) of 71.1% for Siriraj-LBC and 97.8% for conventional cytology, and a negative predictive value (NPV) of 42.2% for the conventional cytology. In conclusion, The results from Siriraj-LBC and conventional cytology have high diagnostic agreement and minimal to fair correlation. The Siriraj-LBC increases detection rate of abnormal cervicovaginal cells with probable decrease in false negatives but increase in false positives from the baseline values by conventional cytology. Therefore the screening performance of Siriraj-LBC is not inferior to the conventional cytology and this approach may be used as an alternative screening method for cervical cancer.
本研究旨在评估诗里拉吉液基宫颈细胞学检查（Siriraj-LBC）与传统细胞学检查之间的相关性和一致性。共有479名到诗里拉吉医院妇产科进行宫颈癌筛查的女性纳入研究。对每位女性均采用VCE技术采集宫颈细胞。在将细胞涂抹在载玻片上进行传统细胞学检查后，将木质刮板和棉签的两端放入装有特定保存液的塑料瓶中用于Siriraj-LBC检查。所有标本均由妇科细胞学室经验丰富的细胞技术人员制备和解读。对一种技术结果的解读不了解另一种技术的结果。比较两种技术的结果以评估一致性和相关性。阴道镜检查或组织学检查用作金标准。Siriraj-LBC对宫颈阴道异常细胞的总体检出率高于传统细胞学检查（11.1%对1.67%，P<0.001）。这两种技术的诊断一致性较高，为89.77%，相关性最小至中等，Kappa值为0.128（P<0.001），Spearman等级相关系数为0.394（P<0.001）。有49例Siriraj-LBC显示的细胞学分级高于传统细胞学检查；没有出现相反结果的病例。在45例Siriraj-LBC细胞学异常的病例中可获得金标准，Siriraj-LBC的阳性预测值（PPV）为71.1%，传统细胞学检查为97.8%，传统细胞学检查的阴性预测值（NPV）为42.2%。总之，Siriraj-LBC和传统细胞学检查的结果具有较高的诊断一致性和最小至中等的相关性。Siriraj-LBC提高了宫颈阴道异常细胞的检出率，可能减少了传统细胞学检查基线值的假阴性，但增加了假阳性。因此，Siriraj-LBC的筛查性能不低于传统细胞学检查，这种方法可作为宫颈癌的替代筛查方法。
