Objective:To explore the application of cervical cancer screening system,TruScreen in detecting atypical squamous cell of undetermined significance(ASCIIS) patients.Methods:A total of 42 cases were selected,who were d...Objective:To explore the application of cervical cancer screening system,TruScreen in detecting atypical squamous cell of undetermined significance(ASCIIS) patients.Methods:A total of 42 cases were selected,who were diagnosed as ASCIIS by thinprep cytologic test(TCT).Area from site 15 to 20,site 21 to 32 were detected by TruScreen.And the result was compared with those of cases which had positive pathological result of cervical biopsy.Results:There were 16 cases with abnormal pathological result in ASCUS cases,including 6 cases with cervical intraepithelial neoplasia(CIN)Ⅰ,6 cases with CINⅡ,3 cases with CINⅢand 1 case with infiltrating carcinoma. The consistency between TCT and pathological test was 38.10%(16/42).The positive rate of TruScreen at site 15-20 was 61.91%(26/42).There was significant difference in consistency with pathological test between TCT and TruScreen(x^2=4.762,P=0.029).The positive rate of TruScreen at site 21-32 was 66.67%(28/42)(Kappa=0.181,P=0.016).There was significant difference in consistency with pathological test between TCT and TruScreen(x^2=9.4919,P=0.002).And no case was missed when site 21-32 of patients with CINⅡand above were detected by TruScreen. Conclusions:TruScreen is effective in detecting ASCUS patients.展开更多
Introduction: Pap smear is a well known test in screening of epithelial cell abnormalities of the cervix. However, adding other screening methods to this test may increase the sensitivity and specificity of case findi...Introduction: Pap smear is a well known test in screening of epithelial cell abnormalities of the cervix. However, adding other screening methods to this test may increase the sensitivity and specificity of case finding. Current study has been designed to assess the sensitivity and specificity of the combination of Tru-Screen and Pap tests in comparison to Pap smear alone in women referred for annual screening. Methods: This case-control study was conducted in two groups of 66 and 73 women with epithelial cell abnormality and normal results on Pap smear, respectively. Both groups were subsequently tested with Tru-Screen and colposcopy. Positive finding in any of the three studies made the patient candidate for biopsy as the standard diagnostic test. SPSS software was used to analyze sensitivity, specificity, positive predictive value, and negative predictive value of TruScreen, Pap smear, colposcopy and the combination of TruScreen and Pap tests. Results: 105 out of 139 women underwent biopsy. Of these, 32 (30.5%) had abnormal result in biopsy. Combination of True screen and Pap smear led to a sensitivity of 93.8% and specificity of 79.5% which means an improvement in both parameters. False negative rate decreased to 6.3% but false positive rate increased to 82.2%. Positive and negative predictive values of the combined tests were 33.3% and 86.7%, respectively. Conclusion: Combination of TruScreen and Pap smear is associated with a significant improvement in both sensitivity and specificity for early screening of preneoplastic and neoplastic cervical epithelial lesions.展开更多
目的评价实时光电学设备TruScreen检测技术在人群宫颈癌筛查中的价值。方法研究对象为2007年3月至2007年12月参加北京大学深圳医院针对深圳市贫困女性进行的宫颈癌筛查的妇女391名,年龄20～67岁。对所有接受筛查的妇女采用实时光电学...目的评价实时光电学设备TruScreen检测技术在人群宫颈癌筛查中的价值。方法研究对象为2007年3月至2007年12月参加北京大学深圳医院针对深圳市贫困女性进行的宫颈癌筛查的妇女391名,年龄20～67岁。对所有接受筛查的妇女采用实时光电学设备TruScreen进行宫颈癌筛查,并采集宫颈脱落细胞,以液基细胞学技术行宫颈细胞学检查,以第二代杂交捕获(HC-Ⅱ)技术进行高危型HPV-DNA(HR-HPV)检测。筛查同时行阴道镜检查,对阴道镜疑诊低度鳞状上皮内病变(LSIL)及以上病变者,在可疑病变处取活检。为客观评价各种筛查方法,对各检测结果均采取盲法保存,于各检测结果确定后解盲。凡HC-Ⅱ检测HR-HPV阳性伴液基细胞学≥ASCUS,和(或)液基细胞学≥LSIL及TruScreen检查结果阳性,而筛查当时未取活检(阴道镜诊断非LSIL及以上病变)者,均于3个月内再次阴道镜下活检,明确诊断。病理为CINⅡ及以上病变者行宫颈电热圈坏切术(LEEP)手术,并取活检。有多次病理检查者以其中最高级别病理结果为该患者的最终诊断,病理诊断作为本研究4种筛查方法的评价标准。结果病理诊断CIN I 110例、CINⅡ5例、CINⅢ7例、宫颈浸润癌5例;慢性宫颈炎和鳞状上皮化生59例。TruScreen检测阳性率为28.2%;液基细胞学检测无明确诊断意义的鳞状上皮细胞病变(ASCUS)以上为23.3%,LSIL以上为7.2%;HR-HPV阳性率为34.3%。TruScreen、液基细胞学及HC-Ⅱ法HPV检查,各筛查方法对检出≥CINⅡ病变的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为76.5%、77.3%、77.2%、13.3%和98.6%;液基细胞学以≥ASCUS为阳性各筛查评价指标分别为88.2%、79.7%、80.1%、16.5%和99.3%;以LSIL为阳性界值各指标为70.6%、95.7%、94.6%、42.9%和98.6%;HC-Ⅱ法HPV为94.1%、68.5%、69.6、11.9%和99.6%。结论实时光电学设备TruScreen进行宫颈癌初筛,筛查效率指标中虽敏感性不及HC-Ⅱ法HPV检测高,但与宫颈细胞学检查相当。作为一种新的宫颈癌筛查技术,具有检测无创无痛、用时较短、实时报告结果等优点,适用于贫困地区大样本人群筛查。展开更多
基金Scientific Research Project of Health Department of Hainan Province(No.2009-64)
文摘Objective:To explore the application of cervical cancer screening system,TruScreen in detecting atypical squamous cell of undetermined significance(ASCIIS) patients.Methods:A total of 42 cases were selected,who were diagnosed as ASCIIS by thinprep cytologic test(TCT).Area from site 15 to 20,site 21 to 32 were detected by TruScreen.And the result was compared with those of cases which had positive pathological result of cervical biopsy.Results:There were 16 cases with abnormal pathological result in ASCUS cases,including 6 cases with cervical intraepithelial neoplasia(CIN)Ⅰ,6 cases with CINⅡ,3 cases with CINⅢand 1 case with infiltrating carcinoma. The consistency between TCT and pathological test was 38.10%(16/42).The positive rate of TruScreen at site 15-20 was 61.91%(26/42).There was significant difference in consistency with pathological test between TCT and TruScreen(x^2=4.762,P=0.029).The positive rate of TruScreen at site 21-32 was 66.67%(28/42)(Kappa=0.181,P=0.016).There was significant difference in consistency with pathological test between TCT and TruScreen(x^2=9.4919,P=0.002).And no case was missed when site 21-32 of patients with CINⅡand above were detected by TruScreen. Conclusions:TruScreen is effective in detecting ASCUS patients.
文摘Introduction: Pap smear is a well known test in screening of epithelial cell abnormalities of the cervix. However, adding other screening methods to this test may increase the sensitivity and specificity of case finding. Current study has been designed to assess the sensitivity and specificity of the combination of Tru-Screen and Pap tests in comparison to Pap smear alone in women referred for annual screening. Methods: This case-control study was conducted in two groups of 66 and 73 women with epithelial cell abnormality and normal results on Pap smear, respectively. Both groups were subsequently tested with Tru-Screen and colposcopy. Positive finding in any of the three studies made the patient candidate for biopsy as the standard diagnostic test. SPSS software was used to analyze sensitivity, specificity, positive predictive value, and negative predictive value of TruScreen, Pap smear, colposcopy and the combination of TruScreen and Pap tests. Results: 105 out of 139 women underwent biopsy. Of these, 32 (30.5%) had abnormal result in biopsy. Combination of True screen and Pap smear led to a sensitivity of 93.8% and specificity of 79.5% which means an improvement in both parameters. False negative rate decreased to 6.3% but false positive rate increased to 82.2%. Positive and negative predictive values of the combined tests were 33.3% and 86.7%, respectively. Conclusion: Combination of TruScreen and Pap smear is associated with a significant improvement in both sensitivity and specificity for early screening of preneoplastic and neoplastic cervical epithelial lesions.
文摘目的评价实时光电学设备TruScreen检测技术在人群宫颈癌筛查中的价值。方法研究对象为2007年3月至2007年12月参加北京大学深圳医院针对深圳市贫困女性进行的宫颈癌筛查的妇女391名,年龄20～67岁。对所有接受筛查的妇女采用实时光电学设备TruScreen进行宫颈癌筛查,并采集宫颈脱落细胞,以液基细胞学技术行宫颈细胞学检查,以第二代杂交捕获(HC-Ⅱ)技术进行高危型HPV-DNA(HR-HPV)检测。筛查同时行阴道镜检查,对阴道镜疑诊低度鳞状上皮内病变(LSIL)及以上病变者,在可疑病变处取活检。为客观评价各种筛查方法,对各检测结果均采取盲法保存,于各检测结果确定后解盲。凡HC-Ⅱ检测HR-HPV阳性伴液基细胞学≥ASCUS,和(或)液基细胞学≥LSIL及TruScreen检查结果阳性,而筛查当时未取活检(阴道镜诊断非LSIL及以上病变)者,均于3个月内再次阴道镜下活检,明确诊断。病理为CINⅡ及以上病变者行宫颈电热圈坏切术(LEEP)手术,并取活检。有多次病理检查者以其中最高级别病理结果为该患者的最终诊断,病理诊断作为本研究4种筛查方法的评价标准。结果病理诊断CIN I 110例、CINⅡ5例、CINⅢ7例、宫颈浸润癌5例;慢性宫颈炎和鳞状上皮化生59例。TruScreen检测阳性率为28.2%;液基细胞学检测无明确诊断意义的鳞状上皮细胞病变(ASCUS)以上为23.3%,LSIL以上为7.2%;HR-HPV阳性率为34.3%。TruScreen、液基细胞学及HC-Ⅱ法HPV检查,各筛查方法对检出≥CINⅡ病变的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为76.5%、77.3%、77.2%、13.3%和98.6%;液基细胞学以≥ASCUS为阳性各筛查评价指标分别为88.2%、79.7%、80.1%、16.5%和99.3%;以LSIL为阳性界值各指标为70.6%、95.7%、94.6%、42.9%和98.6%;HC-Ⅱ法HPV为94.1%、68.5%、69.6、11.9%和99.6%。结论实时光电学设备TruScreen进行宫颈癌初筛,筛查效率指标中虽敏感性不及HC-Ⅱ法HPV检测高,但与宫颈细胞学检查相当。作为一种新的宫颈癌筛查技术,具有检测无创无痛、用时较短、实时报告结果等优点,适用于贫困地区大样本人群筛查。
文摘目的:基于图神经网络对比分析宫颈癌筛查系统(truScreen,TS)、宫颈细胞DNA定量检查高危型人乳头瘤病毒(human papillomavirus,HPV)阳性患者中筛查宫颈癌及癌前病变的效果。方法:选取2022年1月至2023年5月于重庆大学附属黔江医院妇科门诊行宫颈癌高危型HPV检测阳性的400例患者为研究对象。对所有研究对象依次进行TS、宫颈细胞DNA定量、阴道镜下组织病理学检查。以组织病理检查为“金标准”,除采用TS系统已有模块外,基于图神经网络进行标识学习,提取特征,随后使用支持向量机(support vector machines,SVM)和随机森林(random forest,RF)等分类器进行分类,计算并比较TS、宫颈细胞DNA定量筛查宫颈癌及癌前病变的灵敏度、特异度、受试者工作特征(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC)、阴性预测值、阳性预测值、与活检病理结果一致性检验统计量Kappa值。结果:TS融合图神经网络筛查宫颈癌及癌前病变的灵敏度、特异度、AUC、阴性预测值、阳性预测值分别为93.75%、95.45%、0.97、98.18%、87.50%,均高于宫颈细胞DNA定量检查(分别为81.25%、90.91%、0.92、96.15%、64.29%)。与活检病理结果的一致性检验显示,TS融合图神经网络与活检病理结果的Kappa值为0.89,高于宫颈细胞DNA定量检查(0.72)。ROC曲线下面积的比较显示,TS融合图神经网络与宫颈细胞DNA定量检查之间存在显著差异。结论:TS融合图神经网络在高危型HPV阳性患者中筛查宫颈癌及癌前病变的效果优于宫颈细胞DNA定量检查,具有较高的准确性和可靠性,可作为一种简单、有效的宫颈癌筛查方法。
