Tao Xiang, Austin R Marshall, Kong Lingfei, Sun Qing, Lv Qinjie, Xu Haimiao, Meng Gang, Huang Xianghua, Hao Min, Zhou Qiao, Zhou Xianrong, Wang Liantang, Zhang Yue, Xu Shuxia, Shi Qingfang, Zhou Qi, Guo Linchuan, Zeng Sien, Wang Yulan, Zhou Jianhua, Nie Xiu, Tian Lixiang, Shen Danhua, Lei Zi, Liu Yixin, Mei Jinhong, Wong Kam Weng, Cheung Annie A Y, Li Juan, Zhu Minghua, Zhao Chengquan
Department of Pathology, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
J Am Soc Cytopathol. 2019 Sep-Oct;8(5):250-257. doi: 10.1016/j.jasc.2019.02.002. Epub 2019 Feb 21.
Cervical cancer rates in China remain high, with only limited opportunistic screening in urban centers and large mostly unscreened rural areas. Cervical cytology practices in China have been changing over the last decade with introduction of The Bethesda System reporting terminology, liquid-based cytology (LBC), and programs for cervical cytology screening of underserved rural populations. An effort was undertaken for the first time to collect nationwide data on cervical cytology laboratory practices in China, a possible first step toward increased standardization and potential development of nationwide cytology quality benchmarks.
Data on cervical cytology practices from 1572 laboratories operating in 26 nationwide Provisional Level Administrative Divisions was collected in an online survey approved through the Obstetrics and Gynecology Hospital of Fudan University in Shanghai.
Over 90% of cervical cytology laboratories in China now solely use Bethesda System reporting terminology. LBC is now the most commonly utilized form of cervical cytology, with lower-cost Chinese-manufactured LBC formulations used in almost 70% of laboratories. Nationwide, significantly higher abnormal cytology rates were reported with LBC than with the conventional Papanicolaou smear (CPS); however, the CPS remains a useful low-cost alternative as China strives to extend cervical screening to large underserved rural areas.
Abnormal cytology rates were not significantly different when different levels of hospitals were compared. The survey identified nationwide opportunities for cytology quality improvement, including low rates of reporting of unsatisfactory cases and low rates for atypical glandular cells.
中国宫颈癌发病率居高不下，仅在城市中心有有限的机会性筛查，广大农村地区大多未开展筛查。在过去十年里，随着引入贝塞斯达系统报告术语、液基细胞学（LBC）以及针对农村贫困人群的宫颈细胞学筛查项目，中国的宫颈细胞学实践一直在发生变化。首次努力收集中国宫颈细胞学实验室实践的全国性数据，这可能是朝着提高标准化以及制定全国细胞学质量基准迈出的第一步。
通过上海复旦大学附属妇产科医院批准的一项在线调查，收集了在全国26个省级行政区运营的1572家实验室的宫颈细胞学实践数据。
目前中国超过90%的宫颈细胞学实验室仅使用贝塞斯达系统报告术语。LBC现在是最常用的宫颈细胞学形式，近70%的实验室使用成本较低的国产LBC制剂。在全国范围内，报告显示LBC的异常细胞学率显著高于传统巴氏涂片（CPS）；然而，由于中国努力将宫颈筛查扩展到农村贫困地区，CPS仍然是一种有用的低成本替代方法。
比较不同级别医院时，异常细胞学率没有显著差异。该调查确定了全国范围内细胞学质量改进的机会，包括不满意病例报告率低和非典型腺细胞报告率低。
