电脑辅助阅片系统对宫颈鳞状上皮内瘤变检出率的有效性观察  

Performance of computer-assisted imaging system in detection of squamous intraepithelial lesion of uterine cervix

作　　者：高英卓[1] 霍云龙[1] 孙寒雪[1] 齐亚飞[1] 王劲欧[1] 吕庆杰[1] 

机构地区：[1]中国医科大学附属盛京医院病理科,沈阳110004

出　　处：《中华病理学杂志》2013年第8期543-546,共4页Chinese Journal of Pathology

摘　　要：目的探讨电脑辅助阅片系统在宫颈细胞学诊断及质量控制中的价值。方法回顾性分析单纯人T阅片宫颈薄层液基细胞学检测病例140580例，电脑辅助阅片宫颈薄层液基细胞学检测病例32885例，统计各级别病变检卅率、不典型鳞状细胞（ASC）／宫颈鳞状上皮内瘤变（SIL）的比值、不能明确意义的不典型鳞状细胞（ASC—US）患者的高危型HPV检测结果、细胞学与组织学诊断的符合率。结果与单纯人工阅片相比，电脑辅助阅片ASC及以上病变的检出率提高0．32％，其中ASC检出率下降0．21％，低级别鳞状上皮内瘤变检出率上升0．22％，高级别鳞状上皮内瘤变及以上病变检出率上升0．31％，ASC／SIL比值南2．59降至1．60。使用电脑辅助阅片系统不改变ASC—US患者的高危型HPV阳性率，不改变细胞学与组织学诊断的符合率，工作效率提高58．33％。结论使用电脑辅助阅片系统可以提高宫颈鳞状上皮内瘤变的检出率，降低ASC／SIL比值，提高诊断精确度，有利于宫颈细胞学诊断质量控制，提高工作效率。Objective To evaluate the performance of computer-assisted imaging system in the detection of cervical squamous intraepithelial lesion and quality-assurance. Methods Manual PAP screening （n = 140 580） and image-assisted screening （ n = 32 885 ） were compared for the detection rates of squamous cell abnormalities, the atypical squamous ceils （ASC） to squamous intraepithelial lesion （SIL） ratio, the positive rates of high risk human papillomavirus （HR-HPV） test in the case of atypical squamous ceils of undetermined significance （ASC-US）, and the correlation between cytopathology and histopathology. Results Compared with manual screening, computer-assisted imaging system showed increased overall positive detection by 0. 32% , decreased detection of ASC by 0. 21% , increased detection of low-grade squamous intraepithelial lesion （LSIL） by 0. 22% , increased detection of high-grade squamous intraepithelial lesion or worse （HSIL） by 0.31%, and decreased ASC to SIL ratio from 2. 59 to 1.60. Computer-assisted imaging system did not change the HR-HPV positive rate of the patients who were ASC-US, or the coincidence rate between cytopathology and histopathology. Moreover, the productivity of the laboratory operation increased 58.33%. Conclusion Computer-assisted imaging system significantly increases the overall positive detection rate of cervical SIL, improves accuracy and work efficiency of screening, decreases the ASC/SIL rate, and strengths the quality-assurance of laboratoiry testing.

关 键 词：宫颈疾病 乳头状瘤病毒 人 诊断 计算机辅助 

分 类 号：R737.33[医药卫生—肿瘤]