Ashfaq R, Liang Y, Saboorian M H
Department of Pathology, University of Texas Southwestern Medical Center at Dallas 75235-9072, USA.
Diagn Cytopathol. 1995 Jul;13(1):31-6. doi: 10.1002/dc.2840130108.
We rescreened 2,238 cervicovaginal smears conventionally prepared with Papanicolaou stain by PAPNET system. The slides screened manually as negative, were sent to PAPNET system. The image tapes were reviewed on a high-resolution monitor, and categorized as negative, unsatisfactory, and atypical. All atypical cases were rescreened manually. Abnormal cases were reviewed by a cytopathologist. Two-thousand one hundred and two (94%) cases rescreened by PAPNET were negative. Nine of 45 unsatisfactory cases by PAPNET were unsatisfactory by manual review. Ninety-one (4.0%) cases by PAPNET were atypical. On manual rescreening, 86 of 91 were negative, 20% showing benign cellular changes; five of 91 were atypical, the atypia, however, not exceeding low-grade category. The detection rate by PAPNET method was 0.2% (five of 2,238 cases). We conclude: 1) In a cytology laboratory with good quality control, PAPNET rescreening does not significantly increase the detection rate. 2) For cytology laboratories without in-house rescreening, PAPNET offers an alternative at a price. 3) The PAPNET system also offers a tool by which a laboratory can occasionally monitor its performance. 4) The cost benefit analysis of the system requires further study and scrutiny.
我们使用PAPNET系统对2238份采用巴氏染色法常规制备的宫颈阴道涂片进行了重新筛查。将人工筛查为阴性的涂片送去PAPNET系统筛查。在高分辨率监视器上查看图像磁带，并将其分类为阴性、不满意和非典型。所有非典型病例均进行人工重新筛查。异常病例由细胞病理学家复查。经PAPNET重新筛查的2102例（94%）为阴性。PAPNET筛查出的45例不满意病例中，有9例经人工复查仍为不满意。PAPNET筛查出的91例（4.0%）为非典型。人工重新筛查时，91例中有86例为阴性，20%表现为良性细胞改变；91例中有5例为非典型，但异型性未超过低级别。PAPNET方法的检出率为0.2%（2238例中有5例）。我们得出结论：1）在质量控制良好的细胞学实验室中，PAPNET重新筛查不会显著提高检出率。2）对于没有内部重新筛查的细胞学实验室，PAPNET以一定代价提供了一种替代方法。3）PAPNET系统还提供了一种实验室偶尔可以用来监测其性能的工具。4）该系统的成本效益分析需要进一步研究和审查。
