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首页> 外文期刊>Acta Cytologica: The Journal of Clinical Cytology and Cytopathology >Sensitivity of the Pap test in detecting high grade lesions: what should be the acceptable cytologic threshold for colposcopic referral?
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Sensitivity of the Pap test in detecting high grade lesions: what should be the acceptable cytologic threshold for colposcopic referral?

机译：Pap检测在检测高级别病变中的敏感性：阴道镜转诊可接受的细胞学阈值应该是多少？

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OBJECTIVE: To devise an optimal cytology threshold for colposcopy referral in resource-limited settings. STUDY DESIGN: Four hundred seventy-two symptomatic women 20-60 years old were screened by both cytology and colposcopy. Onsite biopsy was taken if lesions grade 1 or above were detected on colposcopy. Women found to have cervical intraepithelial neoplasia (CIN) 2 and above lesions on histopathology were stratified according to their cytologic diagnosis (atypical squamous cells of undetermined significance [ASCUS]+ threshold, low grade squamous intraepithelial lesion [LSIL]+ threshold, and high grade squamous intraepithelial lesion [HSIL]+ threshold). The comparative sensitivity, specificity and predictive values in each group were calculated, taking biopsy as the gold standard. RESULTS: The sensitivity of LSIL + cytology to detect CIN 2+ lesions was 91.5% (referral load, 30.7%). While the sensitivity of ASCUS+ cytology threshold was almost the same (92.3%), the referral load was much higher (42.2%).With HSIL+ cytology threshold, though the referral load was reduced substantially (21.9%), the sensitivity also decreased, to 81.5%. CONCLUSION: The results indicate that in order to achieve high sensitivity, the LSIL cytology threshold appears to be optimum for colposcopic referrals.
机译：目的：为资源有限的情况下阴道镜转诊设计最佳细胞学阈值。研究设计：通过细胞学和阴道镜检查筛查了472名20-60岁的有症状女性。如果在阴道镜检查中发现1级或以上病变，则进行活检。根据组织学诊断（具有未确定的显着性[ASCUS] +阈值，低度鳞状上皮内病变[LSIL] +阈值和高级别）在组织病理学上发现宫颈上皮内瘤样病变（CIN）2及以上病变的女性分层鳞状上皮内病变[HSIL] +阈值）。以活检为金标准，计算各组的比较敏感性，特异性和预测值。结果：LSIL +细胞学检测CIN 2+病变的敏感性为91.5％（推荐负荷为30.7％）。虽然ASCUS +细胞学阈值的敏感性几乎相同（92.3％），但引荐负荷要高得多（42.2％）。HSIL +细胞学阈值虽然引荐负荷显着降低（21.9％），但敏感性也有所降低81.5％。结论：结果表明，为了达到高灵敏度，LSIL细胞学阈值对于阴道镜转诊似乎是最佳的。

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