Yang Jing, Tao Kun, Yang Hua, Guo Zhen-Hua, Hu Yue-Mei, Tan Zhen-Yu
Department of Pathology, Shanghai Changning District Hospital, Shanghai 200336, China.
Zhonghua Bing Li Xue Za Zhi. 2013 Sep;42(9):609-12.
To investigate the value of computer-assisted slide-screening system (ThinPrep imaging system, TIS) in the diagnosis of cervical Thinprep smears.
A total of 19 600 ThinPrep smears were collected, including 9800 slides by TIS-assisted screening from September 2011 to March 2012 and 9800 slides by manual screening from September 2010 to April 2011 as control. The detection rates of abnormal cells and common microbial infection by the different screening methods were compared. With histopathological diagnosis of colposcopic biopsy as the gold standard, the screening efficiency and correlation of cytologic diagnosis among different screening methods were analyzed.
Compared with manual screening, the detection rate of abnormal cells in 9800 cases by TIS-assisted screen was increased from 5.4% (525/9800) to 6.8% (665/9800), mainly in the categories of ASCUS and LSIL (P < 0.05). TIS had a higher accordance rate between cytologic diagnosis and histopathological diagnosis in the NILM and ASCUS than that by manual screening. False-negative rate of finding abnormal cells by TIS decreased from 8.5% (17/200) to 0.7% (2/289, P < 0.01) with an increased sensitivity compared to manual screening, although the specificity was similar. Both TIS and manual screening had advantages and disadvantages respectively in the detection of microbial organisms. TIS improved screening efficiency by 50%.
TIS improves not only the screening efficiency but also the detection of abnormal cells with a reduced false negativity, and it therefore has a broad application prospect.
探讨计算机辅助阅片系统(ThinPrep成像系统,TIS)在宫颈液基薄层涂片诊断中的价值。
共收集19600例宫颈液基薄层涂片,其中2011年9月至2012年3月采用TIS辅助筛查9800张涂片,2010年9月至2011年4月采用手工筛查9800张涂片作为对照。比较不同筛查方法对异常细胞和常见微生物感染的检出率。以阴道镜活检组织病理诊断为金标准,分析不同筛查方法的筛查效率及细胞学诊断的相关性。
与手工筛查相比,TIS辅助筛查的9800例中异常细胞检出率从5.4%(525/9800)提高到6.8%(665/9800),主要为非典型鳞状细胞意义不明确(ASCUS)和低度鳞状上皮内病变(LSIL)类别(P<0.05)。在未见上皮内病变或恶性病变(NILM)和ASCUS中,TIS细胞学诊断与组织病理诊断的符合率高于手工筛查。TIS发现异常细胞的假阴性率从8.5%(17/200)降至0.7%(2/289,P<0.01),与手工筛查相比敏感性增加,特异性相似。TIS和手工筛查在微生物检测方面各有优缺点。TIS提高了50%的筛查效率。
TIS不仅提高了筛查效率,还提高了异常细胞的检出率,降低了假阴性率,具有广阔的应用前景。