Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China.
Int J Gynecol Cancer. 2010 Feb;20(2):283-7. doi: 10.1111/IGC.0b013e3181cd1810.
Determine the sensitivity and specificity of optical coherence tomography (OCT) as an adjunct to colposcopy in the detection of cervical intraepithelial neoplasia (CIN) grade 2 or higher in a real-time clinical evaluation.
Optical coherence tomography (OCT) uses infrared light similar to ultrasound pulse-echo imaging. Image resolution is optimal in the 1-to-3-mm range. This study is the third in our series of OCT investigations and our first real-time clinical trial. The study was conducted at the Peking University Shenzhen Hospital, Shenzhen, China.
Nonpregnant women 18 years or older with abnormal cervical cytologic findings or a positive high-risk human papillomavirus test result were recruited. Women were assessed; and diagnoses, recorded by cervical quadrant first with colposcopy, followed by colposcopic directed OCT. A biopsy of the abnormal areas was performed. In normal quadrants, biopsy specimens were obtained at the 2-, 4-, 8-, and 10-o'clock positions at the squamocolumnar junction depending on the quadrant. An endocervical curettage was also done. Individual OCT diagnoses were paired with colposcopic impressions and biopsy specimens to assess its role as a paired secondary screen. Data were analyzed using generalized estimating equations to control for correlation within a woman.
One thousand two hundred thirty-seven paired diagnoses from 299 women were analyzed. Median age was 36 years. Ninety-six women (8%) had a diagnosis of CIN 2 or higher. Evaluation by quadrant showed that the sensitivity for CIN 2 or higher decreased by adding OCT to colposcopy, but the specificity increased from 83% to 93%.
We continue to try to improve sensitivity by improving the near-infrared light source, decreasing the scan time to 8 frames per second, and using a larger diameter (5 mm) fiberoptic probe with a newly designed application specific probe sheath.
在实时临床评估中，确定光学相干断层扫描（OCT）作为阴道镜检查的辅助手段在检测宫颈上皮内瘤变（CIN）2 级或更高级别中的敏感性和特异性。
光学相干断层扫描（OCT）使用类似于超声脉冲回波成像的近红外光。图像分辨率在 1 到 3 毫米范围内最佳。本研究是我们 OCT 系列研究中的第三项，也是我们的首次实时临床试验。该研究在中国深圳北京大学深圳医院进行。
招募年龄在 18 岁及以上、宫颈细胞学异常或高危型人乳头瘤病毒检测阳性的非妊娠妇女。对妇女进行评估；通过阴道镜检查首先记录宫颈象限的诊断，然后记录阴道镜指导下的 OCT 诊断。对异常区域进行活检。在正常象限，根据象限的不同，在宫颈鳞柱状交界的 2、4、8 和 10 点位置取活检标本。还进行了宫颈管搔刮术。将单独的 OCT 诊断与阴道镜检查印象和活检标本配对，以评估其作为配对二级筛查的作用。使用广义估计方程分析数据，以控制同一妇女内的相关性。
对 299 名妇女的 1237 对诊断进行了分析。中位年龄为 36 岁。96 名妇女（8%）诊断为 CIN 2 级或更高级别。按象限评估显示，在阴道镜检查中添加 OCT 后，CIN 2 级或更高级别的诊断敏感性降低，但特异性从 83%提高到 93%。
我们继续尝试通过改进近红外光源、将扫描时间减少到每秒 8 帧以及使用直径较大（5 毫米）的光纤探头和新设计的专用探头护套来提高敏感性。
