Clinical Application of ThinPrep Imaging System in Cervical Cytology

  Objective  To investigate the effectiveness of clinical application of ThinPrep Imaging System (TIS) in cervical cytology.

  Methods  Manual screening results of cervical liquid-based cytology (LBC) specimens from December 2016 to May 2017 and TIS-assisted screening results of LBC specimens 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, histological follow-up results for abnormal cytology and high risk-human papillomavirus (Hr-HPV) positivity for abnormal cytology specimens were analyzed and compared between the two screening methods.

  Results  A total of 17 407 manual screening results of cervical LBC specimens and 16 564 TIS-assisted screening results of LBC specimens were included. The overall abnormal cytology diagnostic rate was significantly higher in TIS-assisted screening than in manual screening (15.21% vs. 9.58%, P < 0.001), with the diagnostic rate of atypical squamous cells, atypical squamous cells without excluding 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 results were statistically different (all P < 0.05). In biopsy follow-up of the patients with abnormal cytology, the histological coincidence rates of TIS-assisted screening were higher than those of manual screening, but the differences were not statistically significant (all P > 0.05). The number of abnormal glandular cells diagnosed by TIS-assisted screening was 1.89 times that of manual screening (53 cases vs. 28 cases), and the number of adenocarcinomas (confirmed by histology) in TIS-assisted screening was 2.3 times as many as that in manual screening (37 cases vs. 16 cases). The Hr-HPV positivity rates of patients with abnormal squamous epithelial cells in TIS-assisted screening and manual screening were not statistically different. Meanwhile, TIS-assisted screening was more time efficient, 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 increased histological compliance rate, which is worthy of further clinical application.