ThinPrep玻片扫描分析影像系统在子宫颈细胞学中的临床应用  

Clinical Application of ThinPrep Imaging System in Cervical Cytology

作　　者：孔令华 肖晓萍 万茹 向阳 KONG Linghua;XIAO Xiaoping;WAN Ru;XIANG Yang(Department of Obstetrics and Gynecology,National Clinical Research Center for Obstetric&Gynecologic Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]国家妇产疾病临床医学研究中心,中国医学科学院北京协和医院妇产科,北京100730

出　　处：《协和医学杂志》2022年第4期613-619,共7页Medical Journal of Peking Union Medical College Hospital

基　　金：首都卫生发展科研专项(2022-1-4011)。

摘　　要：目的探讨ThinPrep玻片扫描分析影像系统(ThinPrep Imaging System,TIS)在子宫颈细胞学中的临床应用效果。方法回顾性分析中国医学科学院北京协和医院妇产科门诊2016年12月至2017年5月宫颈液基细胞学(liquidbased cytology,LBC)样本人工阅片结果以及2017年12月至2018年5月LBC样本TIS辅助阅片结果,分析两种阅片方式的异常细胞学检出率,并随访细胞学异常患者的组织学活检结果以及异常鳞状上皮细胞标本的高危型人乳头瘤病毒(high risk-human papillomavirus,Hr-HPV)阳性率。结果人工阅片共计17407例,TIS辅助阅片共计16564例。与人工阅片相比,TIS辅助阅片的总体异常细胞学检出率显著提高(15.21%比9.58%,P<0.001),其中非典型鳞状上皮细胞、不除外高度鳞状上皮内病变的非典型鳞状上皮细胞、低度鳞状上皮内病变、高度鳞状上皮内病变、不典型腺细胞和腺癌的检出率分别提高了2.77%、0.28%、2.08%、0.35%、0.08%和0.08%,差异均具有统计学意义(P均<0.05)。对细胞学异常患者进行组织学随访,TIS辅助阅片较人工阅片的组织学符合率有所提升,但差异均无统计学意义(P均>0.05)。TIS辅助阅片异常腺细胞的检出数量是人工阅片的1.89倍(53例比28例),经组织学证实的腺癌数量是人工阅片的2.3倍(37例比16例)。TIS辅助阅片与人工阅片鳞状上皮细胞异常患者的Hr-HPV阳性率均无统计学差异(P均>0.05)。同时,TIS辅助阅片时间减少了33%~50%,阅片效率显著提升。结论使用TIS辅助阅片不仅显著提高了宫颈LBC异常检出率和工作效率,组织学符合率亦有所提升,值得临床进一步推广应用。Objective To investigate the effectiveness of clinical application of ThinPrep Imaging System(TIS)in cervical cytology.Methods Manual screening results of cervical liquid-based cytology(LBC)specimens from December 2016 to May 2017 and TIS-assisted screening results of LBC specimens from December 2017 to May 2018 in the Obstetrics and Gynecology Outpatient Clinic of Peking Union Medical College Hospital were retrospectively analyzed.The diagnostic rates of abnormal cytology,histological follow-up results for abnormal cytology and high risk-human papillomavirus(Hr-HPV)positivity for abnormal cytology specimens were analyzed and compared between the two screening methods.Results A total of 17407 manual screening results of cervical LBC specimens and 16564 TIS-assisted screening results of LBC specimens were included.The overall abnormal cytology diagnostic rate was significantly higher in TIS-assisted screening than in manual screening(15.21%vs.9.58%,P<0.001),with the diagnostic rate of atypical squamous cells,atypical squamous cells without excluding high-grade squamous intraepithelial lesion,low-grade squamous intraepithelial lesion,high-grade squamous intraepithelial lesion,atypical glandular cells and adenocarcinoma increasing 2.77%,0.28%,2.08%,0.35%,0.08%and 0.08%,respectively.All results were statistically different(all P<0.05).In biopsy follow-up of the patients with abnormal cytology,the histological coincidence rates of TIS-assisted screening were higher than those of manual screening,but the differences were not statistically significant(all P>0.05).The number of abnormal glandular cells diagnosed by TIS-assisted screening was 1.89 times that of manual screening(53 cases vs.28 cases),and the number of adenocarcinomas(confirmed by histology)in TIS-assisted screening was 2.3 times as many as that in manual screening(37 cases vs.16 cases).The Hr-HPV positivity rates of patients with abnormal squamous epithelial cells in TIS-assisted screening and manual screening were not statistically different.Meanwhile,TIS

关 键 词：计算机辅助阅片 人工阅片 子宫颈细胞学 人乳头瘤病毒 

分 类 号：R361.3[医药卫生—病理学] R73[医药卫生—基础医学]