电脑辅助阅片系统在宫颈鳞状上皮内瘤变诊断中的价值评价

目的评价电脑辅助阅片系统（TIS）在宫颈鳞状上皮内瘤变诊断中的价值。方法共收集2013年9月～2014年9月期间宫颈液基细胞涂片27 285例,其中经TIS阅片8 685例,以18 600例经人工阅片作为对照,比较两种阅片方法各级别病变检出率、非典型鳞状细胞（ASC）/宫颈鳞状上皮内瘤变（SIL）的比值、细胞学与组织学诊断的符合率。结果与单纯人工阅片相比,TIS阅片ASC及以上病变的检出率提高1.71%,其中ASC检出率提高0.73%,低级别鳞状上皮内瘤变检出率提高0.56%,高级别鳞状上皮内瘤变及以上病变检出率提高0.42%,ASC/SIL比值由4.51降至2.60。TIS阅片不改变细胞学与组织学诊断的符合率,阅片效率提高40%。结论 TIS阅片可以提高宫颈鳞状上皮内瘤变的检出率,下降ASC/SIL比值,提高细胞学诊断的精确度,并提高工作效率。

Evaluation of computer-assisted side-screening system in detection of squamous intraepithelial lesion of uterine cervix

Objective To evaluate the performance of computer-assisted side-screening system（Thin Prep imaging system,TIS） in the detection of squamous intraepithelial lesion of uterine cervix. Methods A total of 27 285 Thin Prep smears were collected, including 8 685 slides by TIS-assisted screening and 18 600 slides by manual screening from September 2013 to September 2014 as control. The detection rates of squamous cell abnormalities, the atypical squamous cells（ASC） to squamous intraepithelial lesion（SIL） ratio, and the correlation between cytopathology and histopathology were compared. Results Compared with manual screening, TIS-assisted screening showed increased overall positive detection with 1.71%, increased detection of ASC with 0.73%, increased detection of low-grade squamous intraepithelial lesion（LSIL） with 0.56%, increased detection of high-grade squamous intraepithelial lesion or worse（HSIL） with0.42%, and decreased ASC to SIL ratio from 4.51 to 2.60. TIS did not change the coincidence rate between cytopathology and histopathology. Moreover, the productivity of the laboratory operation increased 40%. Conclusion Computer-assisted Thin Prep imaging system significantly increases the overall positive detection rate of cervical SIL, decreases the ASC/SIL rate, improves accuracy and work efficiency of screening.