He Xiu-kui, Luo Xi-ping, Mao Ling-zhi, Chen Gui-ying, Li Yun, Zhang Jiang-yu
Guangdong Provincial Women and Children's Hospital, Guangzhou 510010, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 Oct;30(10):2304-6.
To study the clinical value of optoelectronic cervical cancer screening system (TruScreen, TS) in the screening of cervical cancer in comparison with cervical cytology test.
A total of 392 patients were screened by TS, Pap, TCT, and HPV using the pathological and colposcopical results as the golden standard. The sensitivity, specificity, Kappa value and the area of under ROC of each method and their combinations (parallel tests) were compared.
The sensitivity of TS, Pap, TCT and HPV were 32.2%, 42.2%, 74.4% and 47.8%, with specificity of 96.7%, 93.7%, 78.8% and 84.8% in detecting cervical cancer, respectively. The sensitivity of the parallel tests, namely TCT/HPV, TCT/TS, Pap/TS and HPV/TS were 65.6%, 87.8%, 82.2% and 86.7%, with the specificity of 81.1%, 74.5%, 75.8% and 67.2%, respectively. In light of the areas of under ROC, significant differences were noted between the parallel tests of TS/Pap and TS/TCT (P<0.05), but not between TCT/Pap and TCT/TS (P>0.05); significant differences were found between the parallel tests with TS and those without TS (P<0.05), but not between TS alone and the parallel tests incorporating TS (P>0.05), nor between the 4 parallel tests (P>0.05).
As a new modality for early screening of cervical carcinoma, TS offers a means for real-time cancer detection with better diagnostic efficacy than Pap and HPV and equivalent efficacy to TCT. The combination of TS and cytological tests can further enhance the diagnostic accuracy.
比较光电宫颈癌筛查系统（TruScreen，TS）与宫颈细胞学检查在宫颈癌筛查中的临床价值。
以病理及阴道镜检查结果为金标准，对392例患者进行TS、巴氏涂片（Pap）、液基薄层细胞学检测（TCT）及人乳头瘤病毒（HPV）检测。比较各方法及其联合检测（平行试验）的灵敏度、特异度、Kappa值及ROC曲线下面积。
TS、Pap、TCT及HPV检测宫颈癌的灵敏度分别为32.2%、42.2%、74.4%及47.8%，特异度分别为96.7%、93.7%、78.8%及84.8%。TCT/HPV、TCT/TS、Pap/TS及HPV/TS平行试验的灵敏度分别为65.6%、87.8%、82.2%及86.7%，特异度分别为81.1%、74.5%、75.8%及67.2%。根据ROC曲线下面积，TS/Pap与TS/TCT平行试验之间存在显著差异（P<0.05），但TCT/Pap与TCT/TS之间无显著差异（P>0.05）；含TS与不含TS的平行试验之间存在显著差异（P<0.05），但单独TS与含TS的平行试验之间无显著差异（P>0.05），4种平行试验之间也无显著差异（P>0.05）。
作为一种宫颈癌早期筛查的新方法，TS提供了一种实时癌症检测手段，其诊断效能优于Pap和HPV，与TCT相当。TS与细胞学检查联合可进一步提高诊断准确性。
