Husain O A, Watts K C, Lorriman F, Butler B, Tucker J, Carothers A, Eason P, Farrow S, Rutovitz D, Stark M
Department of Cytology, Charing Cross Hospital, London, UK.
Anal Cell Pathol. 1993 Jan;5(1):49-68.
This paper reports a test of a system for provision of machine assistance in cervical cytology screening. The hypothesis tested was that if the results of examination by a screener of a small number of high-ploidy cells on specially prepared monolayers, automatically selected and presented by the system, were combined with machine measurement of cell and cell population characteristics, it would be possible to distinguish conditions requiring further action on the part of a cytology service from those in which the patient could safely be signed out. The system appeared broadly capable of this discrimination, with a false-negative error not significantly different (for the numbers tested) on CIN1 and more severe cases to that obtaining for routine screening of the parallel PAP smears, and also to results obtained by a panel of three observers. The machine system appeared to do better than other systems in selecting borderline cases for review, but this may have been an artefact of the method of evaluation used: all results were compared with a 'reference diagnosis', which was computed using statistical techniques to integrate diagnostic information from all available sources. The false-negative error-rate of the system amounted to 5% of high-grade cases, 17% of CIN1's and 29% of borderlines, but were not substantially different from the FN rates for other reporting systems on the same material. The proportion of negative cases referred back for full cytological diagnosis was 34%. Despite this high false-positive rate, the system is potentially cost-effective in use.
本文报告了一项关于在宫颈细胞学筛查中提供机器辅助系统的测试。所测试的假设是，如果将系统自动选择并呈现的特制单层上少量高倍体细胞的筛查结果与细胞及细胞群体特征的机器测量结果相结合，就有可能将细胞学服务需要采取进一步行动的情况与患者可安全放行的情况区分开来。该系统似乎大体上能够进行这种区分，对于CIN1及更严重病例，其假阴性误差（就所测试的数量而言）与平行巴氏涂片常规筛查的假阴性误差没有显著差异，并且与由三名观察者组成的小组得出的结果也没有显著差异。在选择临界病例进行复查方面，机器系统似乎比其他系统表现更好，但这可能是所用评估方法造成的假象：所有结果都与一个“参考诊断”进行比较，该“参考诊断”是使用统计技术整合所有可用来源的诊断信息计算得出的。该系统的假阴性错误率在高级别病例中占5%，在CIN1病例中占17%，在临界病例中占29%，但与同一材料上其他报告系统的假阴性率没有实质性差异。被送回进行全面细胞学诊断的阴性病例比例为34%。尽管假阳性率很高，但该系统在实际使用中可能具有成本效益。
