Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
Jpn J Clin Oncol. 2012 Jan;42(1):21-8. doi: 10.1093/jjco/hyr165. Epub 2011 Nov 22.
Cytological examination is inexpensive and relatively simple to carry out and deserves utilization in breast cancer screening. We investigated the status of cytological diagnosis at seven facilities in southern Fukuoka Prefecture, Japan.
We collected data on the criteria for cytological judgments and status of breast cytological diagnosis at seven different facilities in this region.
Among 5693 individuals who underwent breast cytological examination, analyses were conducted on 1250 individuals (22.0%) in whom cytological diagnoses were confirmed by histological diagnoses. Among these patients, cytological diagnosis had an absolute sensitivity of 71.9%, a specificity of 76.0%, a false-negative value of 6.7% and a false-positive value of 0.08%. At three facilities with relatively large numbers of cases (>300), excluding a facility for specialized breast disease, similar trends of high complete sensitivity (94.3, 95.6 and 97.1%, respectively) and low absolute sensitivity (60.4, 74.8 and 57.2%, respectively) were found. No false-negative or false-positive cases were seen in individual facilities with relatively low numbers of cases (<150).
The accuracy of cytological diagnosis at the facilities we surveyed was relatively high compared with the goals of assessment of diagnostic accuracy. However, the performance was dependent on the facility type, i.e. number of cases, staff involved and whether it was specialized or not, making the diagnosis specific for this region. We recommend that management of the accuracy of cytological diagnosis be undertaken jointly by multiple facilities to establish systems in Japan that lead to more useful diagnostic tools.
细胞学检查成本低廉，操作相对简单，因此值得在乳腺癌筛查中应用。我们对日本福冈县南部 7 家医疗机构的细胞学诊断现状进行了调查。
我们收集了该地区 7 家不同医疗机构细胞学判断标准和乳腺细胞学诊断现状的数据。
在 5693 例行乳腺细胞学检查的个体中，对 1250 例（22.0%）通过组织学诊断确认了细胞学诊断的个体进行了分析。在这些患者中，细胞学诊断的绝对灵敏度为 71.9%，特异性为 76.0%，假阴性率为 6.7%，假阳性率为 0.08%。在 3 家病例数较多（>300 例）的机构中，除了一家专门的乳腺疾病机构外，相似的高完全灵敏度（分别为 94.3%、95.6%和 97.1%）和低绝对灵敏度（分别为 60.4%、74.8%和 57.2%）趋势被发现。在病例数相对较少（<150 例）的个别机构中，未发现假阴性或假阳性病例。
与诊断准确性评估目标相比，我们调查的医疗机构的细胞学诊断准确性相对较高。然而，其性能取决于机构类型，即病例数量、参与人员以及是否专门从事该领域，使得该地区的诊断具有特异性。我们建议多个机构共同管理细胞学诊断的准确性，以在日本建立更有用的诊断工具系统。
