Berger B M
Department of Pathology and Laboratory Medicine, Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA.
Acta Cytol. 1997 Jan-Feb;41(1):173-81. doi: 10.1159/000332320.
To evaluate the effect of Pathfinder (CompuCyte Corp., Cambridge, Massachusetts, U.S.A.), a process control instrument for microscopes used by cytotechnologists to monitor the mechanical aspects of their screening process, on the false negative cervical cytologic smear rate as detected in daily quality assurance rescreening.
Pathfinder was put into routine use in a large cytology laboratory. After cytotechnologists were trained in its use, they monitored their time spent screening each slide, the area (percent) of the slide screened and the average percentage of overlap of fields of view. The number of abnormal cases missed in screening before and after the introduction of Pathfinder was determined by rescreening a random 10% of the "negative" cases. The evaluation took place over a nine-month period.
A decrease in the number of missed abnormal cases was identified. The false negative rate for atypical cells of undetermined significance (ASCUS) fell from 37/2,336 (1.6%) to 12/1,772 (0.7%), for a 56% decrease. The change in the number of squamous intraepithelial lesion cases, even over a nine-month period, was too small for comment.
The effect of the continuous feedback and process standardization provided by the Pathfinder system was a decrease in the number of abnormal cases missed. This was due primarily to a marked decrease in the number of ASCUS cases missed. The Pathfinder provides a number of innovative management tools to ensure consistent high quality screening.
评估Pathfinder（美国马萨诸塞州剑桥市CompuCyte公司）这一由细胞技术人员用于显微镜检查过程控制的仪器，对日常质量保证复查中检测到的宫颈细胞学涂片假阴性率的影响。
Pathfinder在一家大型细胞学实验室投入日常使用。细胞技术人员接受该仪器使用培训后，他们监测每张玻片的筛查时间、玻片筛查面积（百分比）以及视野平均重叠百分比。通过对随机抽取的10%“阴性”病例进行复查，确定引入Pathfinder前后筛查中漏诊的异常病例数。评估为期九个月。
发现漏诊的异常病例数有所减少。意义不明确的非典型细胞（ASCUS）的假阴性率从2336例中的37例（1.6%）降至1772例中的12例（0.7%），下降了56%。鳞状上皮内病变病例数的变化，即使在九个月期间，也因变化过小而无法评论。
Pathfinder系统提供的持续反馈和流程标准化的作用是减少了漏诊的异常病例数。这主要归因于ASCUS漏诊病例数的显著减少。Pathfinder提供了许多创新的管理工具，以确保始终如一地进行高质量筛查。
