Sato Masakazu, Shintani Daisuke, Hanaoka Mieko, Sato Sho, Miwa Maiko, Ogasawara Aiko, Yabuno Akira, Kurosaki Akira, Yoshida Hiroyuki, Fujiwara Keiichi, Hasegawa Kosei
Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama 350-1298, Japan.
Mol Clin Oncol. 2021 Oct;15(4):207. doi: 10.3892/mco.2021.2370. Epub 2021 Aug 9.
Digital colposcopy built around a smartphone is becoming common, and this has advantages for telemedicine and data sharing by taking advantage of smartphone characteristics. However, digital colposcopy itself is not allowed in clinical practice in Japan. The aim of the present study was to investigate the feasibility of mobile digital colposcopy incorporating a smartphone for management of cervical screening in Japanese patients. Patients who underwent colposcopy at Saitama Medical University International Medical Center between July 2019 and February 2020 were enrolled in the present study. The inclusion criteria were women aged 21-65 years old referred for colposcopy following the Japanese standard of care. Written informed consent was obtained from all patients. A total of 40 patients (52 tests) were included in the study. Following the standard of care, acetic acid was applied to the cervix, which was then visualized using a traditional colposcope, with biopsies collected as necessary. The cervix was then visualized and an imaged was captured using a mobile digital colposcope incorporating a smartphone (EVA System; Mobile ODT). All images were collected before biopsy. Images were stored on a secure cloud portal for subsequent evaluation by the provider who performed the conventional colposcopy, and the diagnoses were compared. The present study was approved by the Institutional Review Board of Saitama Medical University International Medical Center (Hidaka, Japan). The match rates for diagnoses were 75%. The match rates for the actual (from conventional colposcopy) and assumed (from digital colposcopy) biopsy sites were 61, 16 and 23%, based on definitions of the 'same', 'almost the same' and 'different', respectively. The present results indicated that ≥75% cases were equivalent in digital colposcopy and conventional colposcopy. This suggests that digital colposcopy may not be inferior to conventional colposcopy.
基于智能手机的数字阴道镜检查正变得越来越普遍，通过利用智能手机的特性，这对远程医疗和数据共享具有优势。然而，在日本的临床实践中，数字阴道镜检查本身是不被允许的。本研究的目的是探讨结合智能手机的移动数字阴道镜检查在日本患者宫颈筛查管理中的可行性。2019年7月至2020年2月期间在埼玉医科大学国际医疗中心接受阴道镜检查的患者被纳入本研究。纳入标准为按照日本护理标准转诊进行阴道镜检查的21至65岁女性。所有患者均获得了书面知情同意。共有40名患者（52次检查）被纳入研究。按照护理标准，将醋酸应用于宫颈，然后使用传统阴道镜进行观察，并在必要时采集活检样本。然后使用结合智能手机的移动数字阴道镜（EVA系统；移动光学诊断技术）对宫颈进行观察并拍摄图像。所有图像均在活检前采集。图像存储在安全的云平台上，供进行传统阴道镜检查的提供者后续评估，并对诊断结果进行比较。本研究获得了埼玉医科大学国际医疗中心（日本日高）机构审查委员会的批准。诊断的匹配率为75%。根据“相同”、“几乎相同”和“不同”的定义，实际（来自传统阴道镜检查）和假定（来自数字阴道镜检查）活检部位的匹配率分别为61%、16%和23%。目前的结果表明，在数字阴道镜检查和传统阴道镜检查中，≥75%的病例是等效的。这表明数字阴道镜检查可能并不逊色于传统阴道镜检查。
