R-way阴道镜智能诊断评估技术识别宫颈高级别病变的能力

The Capability of R-way Intelligent Colposcopy Evaluation System to Detect High-grade Squamous Intraepithelial Lesion of the Cervix

[目的]探讨R-way阴道镜智能诊断系统识别宫颈高级别病变的能力。[方法]选取498例经阴道镜检查组织病理诊断HSIL+(包括CIN2、CIN3、原位腺癌、浸润癌)的病例,分析阴道镜不同时间、不同检查下的颜色变化,通过"红厚白"、"红白A"、"红白黄"以及阴道镜观察到出血(溃疡)、细胞学异常ASC-H、HSIL、SCC、AGC+(包括AGC-NOS、AGC-FN)、AIS、Adca作为R-way系统评估方法拟诊宫颈高级别病变的指标。[结果]R-way系统的5项指标联合评估宫颈高级别病变的灵敏度为94.78%。最常见的异常指标为"红厚白"、"红白A"、"红白黄"以及细胞学异常ASC-H、HSIL、SCC及AGC+。[结论]R-way诊断系统不同评估指标相结合,可正确识别宫颈高级别病变,但临床应用尚需大样本数据验证其特异度等指标。

[Purpose] To explore the capability of R-way intelligent colposcopy evaluation system to detect high-grade squamous intraepithelial lesion of the cervix. [Methods] The 498 cases of histopathology confirmed HSIL ＋（CIN2,CIN3,carcinoma in situ,invasive cancer） were selected to observed the changes along with the time and staining. The ＂red think white＂,＂red white A（atypical vessels）＂,＂red white yellow＂,bleeding observed under colposcopy and abnormal cytology（ASC-H,HSIL,SCC,AGC including AGC-NOS,AGC-FN,AIS,Adca） were selected as the indicators of R-way evaluation system to detect HSIL＋. [Results] The accumulation detection rate of the five indicators was 94.78%. The ＂red think white＂, ＂red white A（atypical vessels）＂, ＂red white yellow＂ and cytology as ASC-H,HSIL,SCC and AGC＋ were the most frequently found abnormal indicators. [Conclusions] The combination of different indicators of R-way diagnostic system could correctly detect HSIL＋ cases. It is promising but larger sample size study is needed to evaluate the specificity and other validation indicators.