Department of Histology, Diagnostic Medlab Auckland, Ellerslie, Auckland, New Zealand.
Pathology. 2013 Aug;45(5):474-7. doi: 10.1097/PAT.0b013e3283631d63.
Overseas studies have shown equivalent sensitivity and specificity between computer-assisted screening and manual screening, with increased screener productivity. This study was undertaken to test these in a New Zealand laboratory setting.
A total of 9232 slides were read manually alone, and following ThinPrep Imager-assisted screening, and the results compared. Two senior screeners and a cytopathologist reviewed the slides with discordant results.
The detection rate for abnormalities was 7.30% for Imager-assisted screening and 7.83% for manual screening. The concordance in diagnosis of abnormalities ranged from 72.7% to 100% with the lowest concordance for high-grade abnormalities diagnosed by Imager-assisted screening. The rate of unsatisfactory smears with Imager-assisted screening is half that of manual screening. There was a screener productivity increase of 140%. In all but one case, abnormal cells were identified by the Imager but screeners varied in their interpretations.
Overall, Imager-assisted screening was as sensitive as manual screening, and more sensitive for high-grade lesions, with a halving of the rate of unsatisfactory smears. In the setting of the New Zealand cervical screening program, the initial screen by the Imager removes the need for a second, rapid rescreen required by the program for manual screening.
国外的研究表明，计算机辅助筛查与手动筛查之间具有相当的敏感性和特异性，同时提高了筛查者的工作效率。本研究旨在新西兰的实验室环境下对其进行测试。
共有 9232 张载玻片分别进行了单独手动阅读和 ThinPrep Imager 辅助筛查，并对结果进行了比较。两名资深筛查员和一名细胞病理学家对有差异的结果进行了阅片。
Imager 辅助筛查检测到的异常率为 7.30%，而手动筛查为 7.83%。异常诊断的一致性范围为 72.7%至 100%，Imager 辅助筛查诊断的高级别异常的一致性最低。Imager 辅助筛查的不满意涂片率是手动筛查的一半。筛查者的工作效率提高了 140%。除了一例之外，所有异常细胞都被 Imager 识别出来，但筛查者对其解释存在差异。
总体而言，Imager 辅助筛查与手动筛查一样敏感，对高级别病变更敏感，不满意涂片的比例减半。在新西兰宫颈癌筛查计划的背景下，Imager 的初始筛查消除了对手动筛查所需的快速二次筛查的需求。
