TIS在宫颈癌和癌前病变筛查中的价值评价  

Evaluation of computer-assisted ThinPrep imaging system in the screening of cervical cancer and precancerous lesion

作　　者：米贤军[1] 王莹[2] 沈铿[3] 吴秋良[4] 肖琳[2] 陈昂[2] 徐秀梅[1] 孪峰[2] 钟守军[1] 段立锋[1] 

机构地区：[1]南方医科大学附属中山市博爱医院病理科,广东中山528400 [2]南方医科大学附属中山市博爱医院妇科,广东中山528400 [3]中国医学科学院北京协和医院妇产科 [4]中山大学附属肿瘤医院

出　　处：《中国实用医刊》2013年第5期1-4,共4页Chinese Journal of Practical Medicine

基　　金：基金项目：国家科技部“十一五”科技支撑重点项目.子课题（2008BAI58B01）;中山市科技计划项目重大专项（20113A004）

摘　　要：目的评价新柏氏电脑辅助阅片系统（TIS）对宫颈癌及癌前病变的诊断价值。方法收集2011年6月至2012年6月参加中山市大规模免费宫颈癌筛查中妇女的资料，选择做过TIS检测并追踪到有确切组织病理学诊断结果的600例病例为研究对象，将ASCUS／AGC＋病变列为细胞学阳性病例，将CIN1＋病变列为病理学阳性病例，以病理学检查为金标准，评价TIS检测的诊断价值。结果600例妇女中，TIS检测结果为癌（CA）9例，高度鳞状上皮内病变（HSIL）66例，低度鳞状上皮内病变（LSIL）104例，不除外高度鳞状上皮内病变的不典型鳞状细胞（ASC—H）21例，非典型鳞状细肜非典型腺细胞（ASCUS／AGC）30例，正常（WNL）370例。以病理学诊断结果为金标准，TIS检测的灵敏度为93．95％，特异度为92．73％，约登指数为0．867，阳性似然比12．92，阴性似然比0．065，Kappa值0．854，总符合率为93．17％，阳性预测值87．83％，阴性预测值96．49％。TIS与病理学结果的符合率在CA、HSIL、LSIL中分别为100％、90．91％和72．12％，TIS对CA和HSIL的符合率高于LSIL（P〈0．01）。结论TIS对宫颈癌及癌前病变有较高的诊断价值，特别是对CA和HSIL。它是一种高效、高质量和高准确率的宫颈癌及癌前病变筛查技术。Objective To study the diagnostic value of computer-assisted ThinPrep imaging system（TIS） in the screening of cervical cancer and precancerous lesion. Methods The clinical data of 600 cases who participated voluntarily in the screening of large-scale cervical cancer for free in Zhongshan were collected from June 2011 to June 2012. ASCUS/AGC and above were postive cytology and the postive results of pathological examination were CIN and above. Histopathological results were used as gold standard to calculate the diagnostic value of TIS technique. Results A total of 600 cases were detected by TIS, and the testing results showed 9 cases of CA, 66 cases of HSIL, 104 cases of LSIL, 21 cases of ASC-H, 30 cases of ASCUS/AGC and 370 cases within normal limits（WNL）. The sensitivity and specificity of TIS was 93.95% and 92.73%. The Youden＇ s index was 0. 867. Positive likelihood ratio was 12.92, while negative likelihood ratio was 0. 065, Kappa value was 0. 854, the consistency rate was 93.17%. Positive predictive value was 87.83% , while negative predictive value was 96.49%. The consistency rate of TIS and histopathology diagnosis was 100% in CA, 90. 91% in HSIL and 72. 12% in LSIL respectively. Chi-square test displayed the diagnosis of CA and HSIL was better than that of LSIL significantly among TIS and pathologic histology （P 〈 0.01 ）. Conclusions TIS shows highly diagnosticefficacy in cervical cancer and precancerous lesion. It is a power-efficient, high-quality and high-accuracy screaning technique of cervical cancer and precancer disease.

关 键 词：新柏氏电脑辅助阅片系统 宫颈癌 癌前病变 诊断效果评价 

分 类 号：R737.33[医药卫生—肿瘤]