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The Application of ThinPrep Imaging System in Clinical Application of Cervical Cytology
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摘要: 目的 探讨ThinPrep玻片扫描分析影像系统(ThinPrep Imaging System,TIS)在子宫颈细胞学中的临床应用效果。 方法 回顾性分析中国医学科学院北京协和医院妇产科门诊2016年12月至2017年5月宫颈液基细胞学(Liquid-based cytology,LBC)样本人工阅片结果以及2017年12月至2018年5月LBC样本TIS辅助阅片结果,分析两种阅片方式的异常细胞学检出率,并随访异常细胞学的组织学活检结果以及异常鳞状上皮细胞标本的高危型人乳头瘤病毒(high risk-human papilloma virus,Hr-HPV)阳性率。 结果 共计人工阅片17407例,TIS辅助阅片16564例。与人工阅片相比,TIS辅助阅片的总体异常细胞学检出率显著提高(15.21%比9.58%,P<0.001),其中非典型鳞状上皮细胞、不除外高度鳞状上皮内病变的非典型鳞状上皮细胞、低度鳞状上皮内病变、高度鳞状上皮内病变、不典型腺细胞和腺癌的检出率分别提高了2.77%、0.28%、2.08%、0.35%、0.08%和0.08%,差异均具有统计学意义(P均<0.05)。对细胞学异常患者进行组织学随访,TIS辅助阅片比人工阅片的组织学符合率有所提升,但差异均无统计学意义(P均>0.05)。TIS辅助阅片异常腺细胞的检出数量是人工阅片的2倍(55例比27例),经组织学证实的腺癌数量是人工阅片的2.3倍(37例比16例)。TIS辅助阅片与人工阅片鳞状上皮细胞异常患者的Hr-HPV阳性率均无统计学差异(P均>0.05)。同时,TIS辅助阅片时间缩短,阅片效率可提升33%~50%。 结论 使用TIS辅助阅片不仅显著提高了宫颈LBC异常检出率和工作效率,组织学符合率亦有所提升,值得临床进一步推广应用。Abstract: Objective To investigate the effectiveness of ThinPrep Imaging System (TIS) in clinical application of cervical cytology. Methods Manual screened results of cervical liquid-based cytology (LBC) specimens from December 2016 to May 2017 and LBC specimens screened results by TIS assisted screening from December 2017 to May 2018 in the Obstetrics and Gynecology Outpatient Clinic of Peking Union Medical College Hospital were retrospectively analyzed. The diagnostic rates of abnormal cytology, the biopsy follow-up for abnormal cytology and high risk-human papilloma virus (Hr-HPV) positivity for abnormal cytology specimens were analyzed and compared between the two screening methods. Results A total of 17 407 manual screened results of cervical LBC specimens and 16 564 LBC specimens screened results by TIS assisted screening were included.The overall abnormal cytology diagnostic rate was significantly higher in TIS assisted screening compared to manual screening (15.21% VS. 9.58%, P<0.001), with the diagnostic rate of atypical squamous cells of undetermined significance, atypical squamous cell cannot exclude high-grade squamous intraepithelial lesion, low-grade squamous intraepithelial lesion, high-grade squamous intraepithelial lesion, atypical glandular cells and adenocarcinoma increasing 2.77%, 0.28%, 2.08%, 0.35%, 0.08% and 0.08%,respectively, all of which were statistically different (all P<0.05). In biopsy follow-up of patients with abnormal cytology, compared with manual screening, the histological coincidence rates of TIS assisted screening have improved, but the differences were not statistically significant (all P>0.05). Twice as many abnormal glandular cells were diagnosed by TIS assisted screening as by manual screening (55 cases VS. 27 cases), and the number of adenocarcinomas confirmed by histology in TIS assisted screening was 2.3 times as many as in manual screening (37 cases VS. 16 cases). The Hr-HPV positivity rates of patients with abnormal squamous epithelial cell result in TIS assisted screening and manual screening were not statistically different. Meanwhile, TIS assisted screening was more time-consuming, with 33%~50% reduction of time. Conclusion The use of TIS assisted screening not only improved the detection rate of abnormal cytology and the work efficiency, but also improved histological compliance rate, which is worthy of further clinical application.
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Key words:
- ThinPrep imaging system /
- cervical lesion /
- human papillomavirus /
- manual screening
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[1] Hou X, Shen G, Zhou L, et al. Artificial Intelligence in Cervical Cancer Screening and Diagnosis[J]. Front Oncol,2022,12:851367. [2] Bao H, Sun X, Zhang Y, et al. The artificial intelligence-assisted cytology diagnostic system in large-scale cervical cancer screening:A population-based cohort study of 0.7 million women[J]. Cancer Med,2020, 9:6896-6906. [3] Hussain E, Mahanta LB, Borah H, et al. Liquid based-cytology Pap smear dataset for automated multi-class diagnosis of pre-cancerous and cervical cancer lesions[J]. Data Brief, 2020,30:105589. [4] Bao H, Bi H, Zhang X, et al. Artificial intelligence-assisted cytology for detection of cervical intraepithelial neoplasia or invasive cancer:A multicenter, clinical-based, observational study[J]. Gynecol Oncol,2020,159:171-178. [5] Wilbur DC, Nayar R. Bethesda 2014:improving on a paradigm shift[J]. Cytopathology,2015, 26:339-342. [6] Heider A, Austin RM, Zhao C. HPV test results stratify risk for histopathologic follow-up findings of high-grade cervical intra-epithelial neoplasia in women with low-grade squamous intra-epithelial lesion Pap results[J]. Acta Cytol, 2011,55:48-53. [7] Levi AW, Harigopal M, Hui P, et al. Use of high-risk human papillomavirus testing in patients with low-grade squamous intraepithelial lesions[J]. Cancer Cytopathol,2011,119:228-234. [8] Thrall MJ, Smith DA, Mody DR. Women >or=30 years of age with low grade squamous intraepithelial lesion (LSIL) have low positivity rates when cotested for high-risk human papillomavirus:should we reconsider HPV triage for LSIL in older women?[J].Diagn Cytopathol, 2010, 38:407-412. [9] Özcan Z, Kimiloğlu E, Iğdem AA, et al. Comparison of the Diagnostic Utility of Manual Screening and the ThinPrep Imaging System in Liquid-Based Cervical Cytology[J]. Turk Patoloji Derg, 2020,36:135-141. [10] Wright TC Jr, Stoler MH, Parvu V, et al. Risk detection for high-grade cervical disease using Onclarity HPV extended genotyping in women, >/=21years of age, with ASC-US or LSIL cytology[J]. Gynecol Oncol, 2019, 154:360-367. [11] Eversole GM, Moriarty AT, Schwartz MR, et al. Practices of participants in the college of american pathologists interlaboratory comparison program in cervicovaginal cytology, 2006[J]. Arch Pathol Lab Med,2010,134:331-335. [12] Harbhajanka A, Chahar S, Michael CW. The pathological outcome of ThinPrep Pap tests diagnosed as glandular cell abnormalities alone versus combined glandular and squamous abnormalities[J]. Diagn Cytopathol, 2019,47:88-93. [13] Zheng B, Austin RM, Liang X, et al. Bethesda System reporting rates for conventional Papanicolaou tests and liquid-based cytology in a large Chinese, College of American Pathologists-certified independent medical laboratory:analysis of 1394389 Papanicolaou test reports[J]. Arch Pathol Lab Med, 2015,139:373-377. [14] Amaral RG, Zeferino LC, Hardy E, et al. Quality assurance in cervical smears:100% rapid rescreening vs. 10% random rescreening[J]. Acta Cytol, 2005,49:244-248. [15] Tavares SB, de Souza NL, Manrique EJ, et al. Internal quality control for cervical cytopathology:comparison of potential false-negatives detected at rapid prescreening and at 100% rapid review[J]. Acta Cytol, 2014,58:439-445. -
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