Liu Dan, Hu Wanliang
Department of Medicine, Jinggangshan University, Ji'an, Jiangxi 343009, P.R. China.
Exp Ther Med. 2019 Sep;18(3):1521-1526. doi: 10.3892/etm.2019.7719. Epub 2019 Jul 1.
The present study aimed to investigate the sensitivity and specificity of combined dynamic spectral imaging (DySI) and routine colposcopy in diagnosing pre-cancerous lesions in subjects with abnormal cytological results. The retrospective study included 146 patients diagnosed with cervical lesions and atypical squamous cells of undetermined significance according to a colposcopy examination. Data from colposcopy clinics were used to evaluate performance of DySI in different histological types. The present study evaluated the clinical performance of two different referral strategies (single diagnosis or combined diagnosis) in combination with a smear test. The sensitivity of DySI and routine colposcopy for detecting severe pre-cancerous cervical disease in patients referred with a borderline histology or mild dyskaryosis was 69% [95% confidence interval (CI): 56-82%] and 43% (95% CI: 28-57%), respectively (P=0.01). However, for the HSIL group, the sensitivity of DySI and routine colposcopy was 64 and 61%, respectively. In the HSIL group, the sensitivity was as high as 85% when the DySI method was combined with routine colposcopy. When the conditions of new screening strategies were applied to remove those patients with a negligible risk, DySI had a higher sensitivity to detect severe pre-cancerous cervical disease than conventional colposcopy. In conclusion, the combined DySI and routine colposcopy strategy had a higher diagnostic sensitivity in subjects with low or high abnormalities on cytological examination, compared with either method separately. The present study suggests that the baseline colposcopy sensitivity may be enhanced with the adjunctive use of DySI, irrespective of the cytology result for referral.
本研究旨在探讨联合动态光谱成像（DySI）与常规阴道镜检查在诊断细胞学结果异常患者癌前病变中的敏感性和特异性。这项回顾性研究纳入了146例经阴道镜检查诊断为宫颈病变和意义不明确的非典型鳞状细胞的患者。来自阴道镜诊所的数据用于评估DySI在不同组织学类型中的表现。本研究评估了两种不同转诊策略（单一诊断或联合诊断）与涂片检查相结合的临床性能。对于转诊的组织学临界或轻度核异质患者，DySI和常规阴道镜检查检测严重宫颈癌前疾病的敏感性分别为69%[95%置信区间（CI）：56 - 82%]和43%（95%CI：28 - 57%）（P = 0.01）。然而，对于高级别鳞状上皮内病变（HSIL）组，DySI和常规阴道镜检查的敏感性分别为64%和61%。在HSIL组中，当DySI方法与常规阴道镜检查相结合时，敏感性高达85%。当应用新的筛查策略条件去除那些风险可忽略不计的患者时，DySI检测严重宫颈癌前疾病的敏感性高于传统阴道镜检查。总之，与单独使用任何一种方法相比，联合DySI和常规阴道镜检查策略在细胞学检查异常程度低或高的患者中具有更高的诊断敏感性。本研究表明，无论转诊的细胞学结果如何，DySI的辅助使用可能会提高基线阴道镜检查的敏感性。
