Tanabodee Jitraporn, Thepsuwan Kitisak, Karalak Anant, Laoaree Orawan, Krachang Anong, Manmatt Kittipong, Anontwatanawong Nualpan
Chonburi Cancer Hospital, Chonburi, Thailand E-mail :
Asian Pac J Cancer Prev. 2015;16(16):7381-4. doi: 10.7314/apjcp.2015.16.16.7381.
This study was conducted to 1206 women who had cervical cancer screening at Chonburi Cancer Hospital. The spilt-sample study aimed to compare the efficacy of abnormal cervical cells detection between liquid-based cytology (LBC) and conventional cytology (CC). The collection of cervical cells was performed by broom and directly smeared on a glass slide for CC then the rest of specimen was prepared for LBC. All slides were evaluated and classified by The Bethesda System. The results of the two cytological tests were compared to the gold standard. The LBC smear significantly decreased inflammatory cell and thick smear on slides. These two techniques were not difference in detection rate of abnormal cytology and had high cytological diagnostic agreement of 95.7%. The histologic diagnosis of cervical tissue was used as the gold standard in 103 cases. Sensitivity, specificity, positive predictive value, negative predictive value, false positive, false negative and accuracy of LBC at ASC-US cut off were 81.4, 75.0, 70.0, 84.9, 25.0, 18.6 and 77.7%, respectively. CC had higher false positive and false negative than LBC. LBC had shown higher sensitivity, specificity, PPV, NPV and accuracy than CC but no statistical significance. In conclusion, LBC method can improve specimen quality, more sensitive, specific and accurate at ASC-US cut off and as effective as CC in detecting cervical epithelial cell abnormalities.
本研究针对1206名在春武里癌症医院进行宫颈癌筛查的女性开展。这项分样本研究旨在比较液基细胞学(LBC)和传统细胞学(CC)在检测异常宫颈细胞方面的效果。通过扫帚采集宫颈细胞,直接涂抹在载玻片上用于传统细胞学检查,然后将剩余标本用于液基细胞学检查。所有玻片均按照贝塞斯达系统进行评估和分类。将两种细胞学检查的结果与金标准进行比较。液基细胞学涂片显著减少了玻片上的炎症细胞和厚涂片。这两种技术在异常细胞学检测率方面没有差异,细胞学诊断一致性高达95.7%。在103例病例中,宫颈组织的组织学诊断被用作金标准。在非典型鳞状细胞不能明确意义(ASC-US)临界值时,液基细胞学的敏感性、特异性、阳性预测值、阴性预测值、假阳性、假阴性和准确性分别为81.4%、75.0%、70.0%、84.9%、25.0%、18.6%和77.7%。传统细胞学的假阳性和假阴性高于液基细胞学。液基细胞学在敏感性、特异性、阳性预测值、阴性预测值和准确性方面高于传统细胞学,但无统计学意义。总之,液基细胞学方法可以提高标本质量,在ASC-US临界值时更敏感、特异和准确,在检测宫颈上皮细胞异常方面与传统细胞学一样有效。