人工智能辅助宫颈薄层液基细胞检查在宫颈癌筛查中的应用  

Application of artificial intelligence assisted thinprep cytologic test for cervical cancer screening

作　　者：张建微 常欢 王亚凡 Zhang Jianwei;Chang Huan;Wang Yafan(Department of Pathology,Shijiazhuang City Maternal and Child Health Care Hospital,Shijiazhuang Hebei 050000,P.R.China;Department of Gynaecology,Shijiazhuang City Maternal and Child Health Care Hospital,Shijiazhuang Hebei 050000,P.R.China)

机构地区：[1]石家庄市妇幼保健院病理科,河北石家庄050000 [2]石家庄市妇幼保健院妇科,河北石家庄050000

出　　处：《中国计划生育和妇产科》2025年第3期87-90,96,共5页Chinese Journal of Family Planning & Gynecotokology

基　　金：河北省卫生健康委员会医学科学研究课题计划项目(项目编号:20240731)。

摘　　要：目的分析与传统人工阅片人工智能(AI)辅助的宫颈薄层液基细胞检查(TCT)在宫颈癌筛查中的应用效果。方法选择2019年1月至2023年5月于石家庄市妇幼保健院行宫颈癌筛查的1050例患者的临床资料。将阴道镜下病理检查结果作为本研究的金标准,对所有患者行TCT,分别采用人工阅片(人工阅片组)和AI辅助TCT(AI辅助阅片组)2种方式对TCT结果进行阅片。比较两种阅片方式下的检出情况及阅片时长,并比较不同阅片方式的阳性预测值、阴性预测值、灵敏度、特异度及准确度。结果1050例样本中,总体阳性率为8.48%,TCT结果≥ASC-US为160例,阳性率为15.24%;TCT结果≥LSIL为74例,阳性率为7.05%;1050例样本中,18~29岁和30岁组人工阅片和AI辅助阅片阳性率比较相当(P>0.05);TCT结果≥LSIL时,18~29岁和30岁组人工阅片和AI辅助阅片阳性率比较相当(P>0.05);AI辅助阅片组的平均阅片时长明显短于人工阅片组(P<0.05);TCT结果≥ASC-US时,人工阅片组、AI辅助阅片组阳性预测值和阴性预测值分别为62.67%、59.03%、100.00%、99.56%;灵敏度和特异度分别为100.00%、95.50%、94.48%、93.86%。TCT结果≥LSIL时,人工阅片、AI辅助阅片组的阳性预测值和阴性预测值分别为83.10%、72.55%、96.94%、98.42%;灵敏度和特异度分别为66.29%、83.14%、98.75%、97.08%。结论病理学医生在使用AI技术辅助TCT以筛查宫颈癌时,相较于仅人工阅片,能够更有效地确保阅片的准确性,并提升细胞学阅片的效率。Objective Analyze the application effect of artificial intelligence(AI)assisted cervical thin-prep cytologic test(TCT)in cervical cancer screening.Methods Clinical research data of 1050 patients who underwent cervical cancer screening at Shijiazhuang Maternal and Child Health Hospital from January 2019 to May 2023 were selected.Using pathological examination under colposcopy as the gold standard for this study,TCT examination was performed on all patients using two methods:manual examination(manual examination group)and AI assisted cervical thin-layer liquid based cell examination(AI assisted examination group).Compared the detection situation and reading time under two different reading methods,and compared the positive predictive value,negative predictive value,sensitivity,specificity,and accuracy of different reading methods.Results Among the 1050 samples,the overall positive rate was 8.48%,and there were 160 cases with TCT results≥ASC-US,with a positive rate of 15.24%;74 cases had TCT results≥LSIL,with a positive rate of 7.05%;Among the 1050 samples,the positive rates of manual and AI assisted film reading were comparable between the 18-29 and 30-years-old groups(P>0.05);when the TCT result is≥LSIL,the positive rates of manual and AI assisted film reading in the 18-29 and 30-years-old groups are comparable(P>0.05);The average viewing time of the AI assisted film reading group was significantly shorter than that of the manual film reading group(P<0.05);When the TCT result was≥ASC-US,the positive and negative predictive values of the manual film reading group and the AI assisted film reading group were 62.67%,59.03%,100.00%,and 99.56%,respectively;The sensitivity and specificity were 100.00%,95.50%,94.48%,and 93.86%,respectively.When the TCT result was≥LSIL,the positive and negative predictive values of the manual and AI assisted film reading groups were 83.10%,72.55%,96.94%,and 98.42%,respectively;The sensitivity and specificity were 66.29%,83.14%,98.75%,and 97.08%,respectively.Conclusion Pathologist

关 键 词：人工阅片 人工智能 宫颈薄层液基细胞检查 宫颈癌筛查 诊断效能 

分 类 号：R711.74[医药卫生—妇产科学]