新柏氏电脑辅助阅片系统TIS在检测子宫颈/阴道鳞状上皮病变中的应用研究

Application of Thin Prep imaging system in detecting cervical/vaginal squamous intraepithelial lesions

目的：比较新柏氏电脑辅助系统（TIS）阅片与单纯人工阅片两种方法在宫颈癌细胞学筛查中的效率、灵敏度和准确性。方法：分别统计单纯人工阅片组和TIS辅助阅片组的每例用时、阳性检出率、活检诊断相符率。结果：总计收集42 430例液基薄层细胞学检测病例,其中单纯人工阅片25 808例,TIS辅助阅片16 622例,数据显示TIS：（1）平均58.9 s·片-1（每小时约60张玻片）,较单纯人工阅片效率提高40%~250%;（2）ASCUS及以上的总阳性检出率、ASCUS、ASC-H和HSIL检出率分别为8.02%、5.43%、0.17%、0.63%,均高于单纯人工阅片,各组差异有统计学意义（P〈0.05）;（3）经活检证实,TIS与人工阅片相比各组诊断相符率差异无统计学意义。结论：TIS明显缩短了医生阅片的筛查时间;在检测宫颈鳞状上皮病变时TIS优于人工阅片,其敏感度提高不以损失特异度来实现。

Objective： To compare the performance of Thin Prep imaging system（ TIS） with manual screening of the slides in terms of efficiency,sensitivity and accuracy in the cytology screening of cervical cancer. Methods：Time to diagnose per case,positive detection rate and rate of accordance with biopsy were sum up for the manual reading group and TIS group respectively. Results： 42 430 cases of Thin Prep cytologic test（ TCT） were aligned into 25 808 cases for manual reading group and 16 622 cases for TIS group. Data showed that：（ 1） mean time to diagnose was 58. 9 seconds per slide which is equivalent with approximately 60 slides per hour,efficiency was approved by 40% ~ 250% comparing to manual reading group;（ 2） total positive detection rate of ASCUS and above,and detection rates of ASCUS,ASC-H and HSIL were 8. 02%,5. 43%,0. 17%,0. 63% respectively in TIS group,which were all higher than those in manual reading group. There was statistical significance between groups（ P〈0. 05）;（ 3） Validation by biopsy showed that comparing TIS with manual reading group,there was no statistical significance in the accordance rate between the two groups. Conclusion： TIS can significantly shorten the time spent on screening,and TIS is superior to manual screening in detecting the cervical / vaginal squamous intraepithelial lesions,generally the improvement of sensitivity is not achieved at the cost of the loss of specificity.