Cenci M, Nagar C, Giovagnoli M R, Vecchione A
Dipartimento di Medicina Sperimentale, Università degli Studi di Roma La Sapienza, Roma.
Minerva Ginecol. 1997 Apr;49(4):139-45.
The Papanicolaou test has reduced mortality from cervical cancer but has not completely eradicated the disease. A reason for the false negative screening errors may be found in one of three steps of the test (obtaining, processing and interpretation of the cervicovaginal smears). The possible false negative primary screening errors may be detected with the help of rescreening. Therefore, an automated quality control by means of a system such as in the PAPNET is necessary. The PAPNET combines the use of algorithmic image analysis with neural networks and allows to conventionally reassess cervicovaginal smears. Nevertheless, the cytopathologist always decides whether to reassess the sample with the optic microscope as suggested by the presence of abnormal cells in the frames selected by the PAPNET system. Therefore the cytopathologist always formulates the conclusive diagnosis.
In this study, we rescreened 300 cervicovaginal smears.
Only 122 smears have been reassessed by the optic microscope. The human papillomavirus infection and the SIL (squamous Intraepithelial Lesion) diagnoses formulated by means of rescreening with the PAPNET have coincided with the primary screening diagnoses. The only exception was a human papillomavirus infection not previously detected.
Our study indicates that the use of the PAPNET system facilitates the quality control measures and has reduced the false negatives.
巴氏试验降低了宫颈癌死亡率,但尚未完全根除该疾病。假阴性筛查错误的一个原因可能存在于检测的三个步骤之一(宫颈阴道涂片的获取、处理和解读)中。借助重新筛查可能检测出可能的假阴性初筛错误。因此,有必要通过诸如PAPNET这样的系统进行自动化质量控制。PAPNET将算法图像分析与神经网络结合使用,并允许对宫颈阴道涂片进行常规重新评估。然而,细胞病理学家始终要根据PAPNET系统所选框架中异常细胞的存在情况,决定是否按照建议用光学显微镜重新评估样本。因此,细胞病理学家始终要做出最终诊断。
在本研究中,我们对300份宫颈阴道涂片进行了重新筛查。
只有122份涂片通过光学显微镜进行了重新评估。通过PAPNET重新筛查得出的人乳头瘤病毒感染和SIL(鳞状上皮内病变)诊断与初筛诊断一致。唯一的例外是一个先前未检测到的人乳头瘤病毒感染。
我们的研究表明,使用PAPNET系统有助于质量控制措施,并减少了假阴性。