Ashfaq R, Saliger F, Solares B, Thomas S, Liu G, Liang Y, Saboorian M H
Department of Pathology, University of Texas Southwestern Medical Center, Dallas 75235-9072, USA.
Acta Cytol. 1997 Jul-Aug;41(4):1058-64. doi: 10.1159/000332788.
To assess the PAPNET System for prescreening triage of cervical smears.
We prospectively prescreened 5,170 consecutive cervicovaginal smears with the PAPNET System. The slides were then manually screened by cytotechnologists blinded to the PAPNET diagnoses. Cases identified as abnormal by either PAPNET or manual screening were reviewed by a cytopathologist. The PAPNET and manual diagnoses were correlated.
Diagnostic concordance between PAPNET and manual screening was seen in 4,340 (84%) of the cases (3,167 negative, 1,038 abnormal and 135 unsatisfactory). Noncorrelation between PAPNET and manual diagnosis occurred in 794 cases (543 abnormal by PAPNET and negative manually, 228 negative by PAPNET and abnormal manually, 8 abnormal by PAPNET and unsatisfactory manually, 29 unsatisfactory by PAPNET and negative manually, 7 negative by PAPNET and unsatisfactory manually). The diagnostic sensitivity of the PAPNET System was 82%, diagnostic specificity 85%, predictive value of a positive test 66% and predictive value of a negative test 93.4%. The false negative fraction of PAPNET was 6.4% for low grade squamous intraepithelial lesion and above.
PAPNET performed effectively for prescreening triage, increasing the accuracy of screening and reducing the screening time.
评估PAPNET系统用于宫颈涂片的预筛查分诊。
我们使用PAPNET系统对5170例连续的宫颈阴道涂片进行前瞻性预筛查。然后由对PAPNET诊断结果不知情的细胞技术人员对玻片进行人工筛查。PAPNET或人工筛查判定为异常的病例由细胞病理学家进行复查。对PAPNET和人工诊断结果进行相关性分析。
4340例（84%）病例中PAPNET与人工筛查的诊断结果一致（3167例阴性、1038例异常和135例不满意）。794例病例中PAPNET与人工诊断结果不相关（543例PAPNET判定为异常而人工判定为阴性，228例PAPNET判定为阴性而人工判定为异常，8例PAPNET判定为异常而人工判定为不满意，29例PAPNET判定为不满意而人工判定为阴性，7例PAPNET判定为阴性而人工判定为不满意）。PAPNET系统的诊断敏感性为82%，诊断特异性为85%，阳性预测值为66%，阴性预测值为93.4%。对于低度及以上鳞状上皮内病变，PAPNET的假阴性率为6.4%。
PAPNET在预筛查分诊中表现有效，提高了筛查准确性并缩短了筛查时间。
