Okagaki T, Fujimura M, Zelterman D
Department of Laboratory Medicine, University of Minnesota Medical School, Minneapolis.
Acta Cytol. 1991 Jan-Feb;35(1):30-4.
The performance of a cytology laboratory can be objectively quantitated as the total discrimination, a defined quantity of information. The total discrimination is dependent on the number of categories used in gynecologic cytology and on the corresponding histologic states; over-classification results in a higher rate of misinformation and reduced total discrimination. Total divergence is another measure of the association between cytologic categories and histologic states; in contrast to the total discrimination, the total divergence does not require a one-to-one correspondence between the cytologic categories and the histologic states. Using data from the Gynecologic Cytology Laboratory of the University of Minnesota, the total discrimination was maximized when gynecologic cytology used three categories of diagnosis, consisting of (1) normal, atypical benign or reactive atypia, (2) cervical intraepithelial neoplasia (CIN) and (3) all malignancies. The use of four categories, (1) normal, atypical benign or reactive atypia, (2) mild or moderate dysplasia, (3) severe dysplasia or squamous carcinoma in situ and (4) all malignancies, was almost equally informative. Observations on the total divergences resulted in similar conclusions. These findings generally support the recommendation of the consensus workshop sponsored by the National Cancer Institute (the Bethesda System nomenclature) to group all degrees of CIN into two large categories.
细胞学实验室的表现可以客观地量化为总辨别力，这是一个定义明确的信息量。总辨别力取决于妇科细胞学中使用的类别数量以及相应的组织学状态；过度分类会导致错误信息率升高，总辨别力降低。总离散度是细胞学类别与组织学状态之间关联的另一种度量；与总辨别力不同，总离散度并不要求细胞学类别与组织学状态之间一一对应。利用明尼苏达大学妇科细胞学实验室的数据，当妇科细胞学使用三类诊断时，总辨别力达到最大值，这三类诊断包括：(1)正常、非典型良性或反应性非典型，(2)宫颈上皮内瘤变（CIN），(3)所有恶性肿瘤。使用四类诊断，即(1)正常、非典型良性或反应性非典型，(2)轻度或中度发育异常，(3)重度发育异常或原位鳞状癌，(4)所有恶性肿瘤，信息量几乎相同。对总离散度的观察得出了类似的结论。这些发现总体上支持了由美国国立癌症研究所主办的共识研讨会（贝塞斯达系统命名法）提出的将所有程度的CIN归为两大类的建议。
