摘要目的 探讨电脑辅助阅片系统(TIS)在宫颈薄层液基细胞涂片诊断中的价值.方法 共收集19 600例液基细胞涂片,其中2011年9月至2012年3月期间9800例经TIS阅片,2010年9月至2011年4月期间9800例经人工阅片作为对照,比较两种阅片方法异常细胞检出率和常见微生物检出率；以阴道镜活检的组织病理学诊断结果作为金标准,比较两种阅片方法诊断的各级病变符合率；比较两种阅片方法的阅片效率.结果 TIS阅片异常细胞检出率为6.8％ (665/9800),较上一年度同期人工阅片检出率(5.4％,525/9800)有提高(P＜0.05),主要是不能明确意义的不典型鳞状上皮细胞(ASCUS)、低度鳞状上皮细胞内病变(LSIL)的检出增加,其他级别病变未见明显提高；比较细胞学诊断与组织病理符合率显示TIS诊断未见癌细胞或癌前病变细胞(NILM)、ASCUS的组织学符合率较人工阅片有提高,其他级别病变两者相近.检出异常细胞假阴性率由8.5％ (17/200)降到0.7％(2/289;P ＜0.01).TIS异常细胞检出的敏感性高于人工阅片,而两者特异性相近.检出微生物感染方面,TIS与人工阅片各有优劣.TIS提高阅片效率达50％.结论 TIS在提高阅片效率的同时增加了异常细胞的检出率,降低了假阴性率.

abstractsObjective To investigate the value of computer-assisted slide-screening system (ThinPrep imaging system,TIS) in the diagnosis of cervical Thinprep smears.Methods A total of 19 600 ThinPrep smears were collected,including 9800 slides by TIS-assisted screening from September 2011 to March 2012 and 9800 slides by manual screening from September 2010 to April 2011 as control.The detection rates of abnormal cells and common microbial infection by the different screening methods were compared.With histopathological diagnosis of colposcopic biopsy as the gold standard,the screening efficiency and correlation of cytologic diagnosis among different screening methods were analyzed.Results Compared with manual screening,the detection rate of abnormal cells in 9800 cases by TIS-assisted screen was increased from 5.4％ (525/9800) to 6.8％ (665/9800),mainly in the categories of ASCUS and LSIL (P ＜ 0.05).TIS had a higher accordance rate between cytologic diagnosis and histopathological diagnosis in the NILM and ASCUS than that by manual screening.False-negative rate of finding abnormal cells by TIS decreased from 8.5％ (17/200) to 0.7％ (2/289,P ＜ 0.01) with an increased sensitivity compared to manual screening,althoughthe specificity was similar.Both TIS and manual screening had advantages and disadvantages respectively in the detection of microbial organisms.TIS improved screening efficiency by 50％.Conclusion TIS improves not only the screening efficiency but also the detection of abnormal cells with a reduced false negativity,and it therefore has a broad application prospect.